Fig. 1. CTA of the pelvis using shaded surface rendering (SSD). The aorta is narrowed. The IMA, inferior epigrastric and uterine vessels provide prominent collateral flow.		Fig. 2. CTA of the abdomen using SSD. Coarctation of the distal aorta and marked enlargement of the IMA are present.

Case Reference No. CC-497-04 During a routine physical exam, this 14-year-old girl was found to have a loud abdominal bruit. She denied any specific complaints on general questioning. She was normotensive. Abdominal ultrasound was unrevealing. A CT angiogram was requested to further evaluate her physical findings. CT angiography demonstrated severe narrowing of the abdominal aorta immediately inferior to the IMA and relatively small-caliber iliac arteries. Normal-vessel caliber was restored at the level of the external iliac arteries via an hypertrophied IMA and other collateral vessels.

Fig. 3. CTA of the abdomen using a maximum intensity projection algorithm (MIP).

Upon further questioning, it was discovered that she had recently given up sports at school because of weakness in her legs. She also admitted that she could not walk up more than two flights of stairs. When she had classes at the upper floors she would climb two flights, walk along the hallway to the next stairwell and continue up the next flight of stairs. Questions 1) Have anyone had any experience with balloon dilatation of this particular lesion in this age group?