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He presented with resistant hypertension and was referred for assessment. MRA demonstrates a discrete severe stenosis at the site of previous coarctation repair. 6 A 13-year-old boy had a surgical repair of an aortic coarctation aged 2 years old. He was referred for follow-up assessment of the repair. MRA demonstrates a narrowed and tortuous aortic arch and descending aorta consistent with a significant re-coarctation (Oblique sagittal images viewed from the right (a) and left (c)). The proximal left subclavian artery is not demonstrated and therefore may have been used for the original repair.

MacMahon S, Rodgers A. Blood pressure, antihypertensive treatment and stroke risk. J Hypertens 1994; 2(suppl):s5–14 2. Collins R, Peto R, MacMahon S, Hebert P, Fiebach NH, Eberlein KA, Godwin J, Qizilbash N, Taylor JO, Hennekens CH. Blood pressure, stroke, and coronary heart disease, part 2: short-term reductions in blood pressure. Overview of randomised drug trials in their epidemiological context. Lancet 1990; 335:827–38 3. SHEP Cooperative Research Group. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension.

Observer variation in the interpretation of intra-arterial angiograms and the risk of inappropriate decisions about carotid endarterectomy. J Neurol Neurosurg Psychiatry 1996; 60:152– 7 18. Gagne PJ, Matchett J, MacFarland D, et al. Can the NASCET technique for measuring carotid stenosis be reliably applied outside the trial? J Vasc Surg 1996; 24:449–6 19. Eliasziw M, Fox AJ, Sharpe BL, Barnett HJ. Carotid artery stenosis: external validity of the North American Symptomatic Carotid Endarterectomy Trial measurement method.

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