Keywords
intermittent claudication
aorta, hypertension
aortic stenosis
How to Cite
Abstract
The middle aortic syndrome is a rare form of presentation of aortic coarctation that
represents 0.5-2% of this same entity. It usually presents in the pediatric or young
adult population; therefore, the age of this patient is of interest. It mainly affects
women with an estimated ratio of 4:1. Renal involvement is the most prevalent, and
idiopathic etiology is the most frequent.
This pathology presents clinically with hypertension challenging to control along with
intermittent claudication. This article comprises the case of an 81-year-old female
patient with a history of hypertension, sedentary lifestyle, smoking, osteoporosis,
cholecystectomy in 2010, and appendectomy in childhood. On this occasion, the
patient had a stenosis of the infrarenal abdominal aorta and a simultaneous superficial
femoral artery lesion and was treated in a hybrid approach with a balloon expandable
stent and a suprapatellar femoral-popliteal bypass.1. Jiménez CE, Randial L, Robles A, Rozo JP. (2019). Coartación
aórtica abdominal en un lactante de tres meses. Tratamiento por vía
endovascular. Revista Colombiana de Cardiología, 26(3), 159-161.
https://doi.org/10.1016/j.rccar.2018.09.004
2. Coleman DM. (2022). Renovascular and aortic developmental
disorder. Rutherford MD, 1714-724.
3. Alvarez Gallesio J, Gimenez Ruiz P, David M, Devoto M, Bertolino T,
Ferreira L. (2020). Abdominal Aortic Coarctation in Noonan Syndrome.
Argentine Journal of Cardiology, 88(6).
4.Hulting B, Vendsalu A. (1955). Coarctation of the Aorta in Unusual
Sites. Acta Radiologica, Original Series, Volume 43(6), 453-458.
https://doi.org/10.1177/028418515504300604
5. Rumman RK, Nickel C, Matsuda-Abedini M, Lorenzo AJ, Langlois
V, Radhakrishnan S, Amaral J, Mertens L, Parekh RS. (2015). Disease
Beyond the Arch: A Systematic Review of Middle Aortic Syndrome in
Childhood. American Journal of Hypertension, 28(7), 833-846.
6. Sumboonnanonda A, Robinson BL, Gedroyc WM, Saxton HM, Reidy
JF, Haycock GB. Middle aortic syndrome: clinical and radiological
findings. Arch Dis Child. 1992;67(4):501-505. http://dx.doi.
org/10.1136/adc.67.4.501
7. Gupta S, Goswami B, Ghosh DC, Sen Gupta AN. (1981). Middle aortic
syndrome as a cause of heart failure in children and its management.
Thorax, 36(1), 63-65. http://dx.doi.org/10.1136/thx.36.1.63
8. Young-Wook K, Kiick Sung YJP, Duk-Kyung K. (2014). Surgical
treatment of middle aortic syndrome due to Takayasu arteritis.
Vascular Images, 62(3), 750-751. http://dx.doi.org/10.1016/j.
jvs.2011.09.051
9. Cheng KCA, Yan-Li L. (2017). Mid-aortic syndrome secondary to
Takayasu’s disease. BMJ Case Reports, 27, 2017–221729. http://
dx.doi.org/10.1136/bcr-2017-221729
10. Sen PK, Kinare SG, Engineer SD, Parulkar GB. (1963). The
Middle Aortic Syndrome. Br Heart J., 25(5):610-6188. http://dx.doi.
org/10.1136/hrt.25.5.610.
11. Che W, Xiong H, Jiang X, Dong H, Zou Y, Yang Y, Gao R. (2018).
Stenting for middle aortic syndrome caused by Takayasu arteritisimmediate
and long-term outcomes. Catheter Cardiovasc Interv,
91(S1), 623-631. http://dx.doi.org/10.1002/ccd.27492.
References
Jiménez CE, Randial L, Robles A, Rozo JP. (2019). Coartación aórtica abdominal en un lactante de tres meses. Tratamiento por vía endovascular. Revista Colombiana de Cardiología, 26(3), 159-161. https://doi.org/10.1016/j.rccar.2018.09.004.
Coleman DM. (2022). Renovascular and aortic developmental disorder. Rutherford MD, 1714-724.
Alvarez Gallesio J, Gimenez Ruiz P, David M, Devoto M, Bertolino T, Ferreira L. (2020). Abdominal Aortic Coarctation in Noonan Syndrome. Argentine Journal of Cardiology, 88(6).
Hulting B, Vendsalu A. (1955). Coarctation of the Aorta in Unusual Sites. Acta Radiologica, Original Series, Volume 43(6), 453-458. https://doi.org/10.1177/028418515504300604.
Rumman RK, Nickel C, Matsuda-Abedini M, Lorenzo AJ, Langlois V, Radhakrishnan S, Amaral J, Mertens L, Parekh RS. (2015). Disease Beyond the Arch: A Systematic Review of Middle Aortic Syndrome in Childhood. American Journal of Hypertension, 28(7), 833-846.
Sumboonnanonda A, Robinson BL, Gedroyc WM, Saxton HM, Reidy JF, Haycock GB. Middle aortic syndrome: clinical and radiological findings. Arch Dis Child. 1992;67(4):501-505. http://dx.doi.org/10.1136/adc.67.4.501.
Gupta S, Goswami B, Ghosh DC, Sen Gupta AN. (1981). Middle aortic syndrome as a cause of heart failure in children and its management. Thorax, 36(1), 63-65. http://dx.doi.org/10.1136/thx.36.1.63.
Young-Wook K, Kiick Sung YJP, Duk-Kyung K. (2014). Surgical treatment of middle aortic syndrome due to Takayasu arteritis. Vascular Images, 62(3), 750-751. http://dx.doi.org/10.1016/j.jvs.2011.09.051.
Cheng KCA, Yan-Li L. (2017). Mid-aortic syndrome secondary to Takayasu’s disease. BMJ Case Reports, 27, 2017–221729. http://dx.doi.org/10.1136/bcr-2017-221729.
Sen PK, Kinare SG, Engineer SD, Parulkar GB. (1963). The Middle Aortic Syndrome. Br Heart J., 25(5):610-6188. http://dx.doi.org/10.1136/hrt.25.5.610.
Che W, Xiong H, Jiang X, Dong H, Zou Y, Yang Y, Gao R. (2018). Stenting for middle aortic syndrome caused by Takayasu arteritisimmediate and long-term outcomes. Catheter Cardiovasc Interv, 91(S1), 623-631. http://dx.doi.org/10.1002/ccd.27492.