Background: Aortic coarctation is a congenital narrowing of the thoracic aorta that may present with upper-limb hypertension, lower-limb hypoperfusion, heart failure, or late vascular complications. Endovascular therapy has become an important treatment option, especially in adolescents and adults.

Objective: To evaluate procedural success, blood pressure improvement, complications, and mid-term outcomes after balloon angioplasty and stent implantation for aortic coarctation.

Methods: A prospective observational study was conducted among 96 patients with native or recurrent aortic coarctation treated endovascularly between January 2021 and December 2024. Clinical, imaging, procedural, and follow-up data were analyzed.

Results: Mean age was 19.8±8.7 years. Native coarctation was present in 72.9% and recoarctation in 27.1%. Stent implantation was performed in 78.1%, while balloon angioplasty alone was used in 21.9%. Technical success was achieved in 97.9%. Mean peak systolic gradient decreased from 48.6±15.4 mmHg to 8.7±5.6 mmHg. At 12 months, systolic blood pressure decreased from 156.8±18.9 mmHg to 128.4±12.7 mmHg. Major complications occurred in 4.2%.

Conclusion: Endovascular management of aortic coarctation is safe and effective, with high procedural success, marked gradient reduction, improved blood pressure control, and acceptable complication rates. Stent implantation is preferred in adolescents and adults with suitable anatomy.