Middle Aortic Syndrome with Superior Mesenteric and Bilateral Renal Artery Involvement: Unusual Type of Aortic Coarctation

JongSeon Park

doi:10.5646/jksh.2013.19.1.39

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Park: Middle Aortic Syndrome with Superior Mesenteric and Bilateral Renal Artery Involvement: Unusual Type of Aortic Coarctation

Case Report

J Korean Soc Hypertens 2013;19(1):39-43.

Published online: 10 March 2013

DOI: https://doi.org/10.5646/jksh.2013.19.1.39

Middle Aortic Syndrome with Superior Mesenteric and Bilateral Renal Artery Involvement: Unusual Type of Aortic Coarctation

JongSeon Park, MD

Division of Cardiology, Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Korea

Correspondence to: JongSeon Park, MD Address: Division of Cardiology, Department of Internal Medicine, Veterans Health Service Medical Center, 53 Jinhwangdo-ro 61-gil, Gangdong-gu, Seoul 134-791, Korea Tel: +82-2-2225-1304, Fax: +82-2-2225-1491 E-mail: neo00100@daum.net

Received 15 February 201326 March 2013 Accepted 26 March 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

ABSTRACT

Middle aortic syndrome (MAS) is very uncommon vascular pathology characterized by a long segmental narrowing or obstruction of the abdominal and/or distal thoracic aorta, commonly involving with the visceral and renal arteries. This syndrome may be presented with various physical signs of coarctation of the aorta, including resistant hypertension, renal insufficiency and/or mesenteric ischemia. Here, we report a case of a 64-year-old man with severe hypertension. He was diagnosed with MAS associated with stenosis of visceral and renal vessels by use of computed tomography and magnetic resonance angiography.

Keywords: Aortic coarctation, Abdominal aorta, Hypertension

References

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Fig. 1.

Imaging of computed tomography (CT) and magnetic resonance angiography (MRA). (A) Origin of right renal artery (arrow) was not found around aorta, supplied by branch vessels arose from distal superior mesenteric artery and left renal artery. (B) Left renal artery (arrow) originating from hypoplastic abdominal aorta was severely calcified and stenosed. (C) Abrupt luminal obstruction of abdominal aorta just below the celiac trunk (Upper arrow). Superior mesenteric artery is supplied by the arc of Riolan (Lower arrow). Both iliac arteries are normal. (D) MRA showing similar but more detailed vasculature as compared with CT.

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