Physiologic coarctation of the aorta resulting from proximal protrusion of thoracic aortic stent grafts into the arch

Graft collapse is a known complication of thoracic aortic stent grafting, particularly in cases of traumatic thoracic aortic transection, when a typically smaller diameter aorta is repaired with a relatively large diameter device. In contrast, obstruction of the aorta from a stent graft that protrudes into the aortic arch but does not collapse is a less common complication of thoracic aortic stent grafting that can present as a functional aortic coarctation. We describe here two cases of physiologic coarctation of the aorta caused by stent graft protrusion into the arch that were successfully treated with stent graft explantation and open aortic reconstruction.