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J Am Coll Cardiol, 2010; 56:521, doi:10.1016/j.jacc.2010.01.066
© 2010 by the American College of Cardiology Foundation
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IMAGES IN CARDIOLOGY

Middle Aortic Syndrome

Percutaneous Treatment With a Balloon-Expandable Covered Stent

Martin Rabellino, MD*, Luis Garcia-Nielsen, MD{dagger}, Gabriela Gonzalez, MD*, Sebastian Baldi, MD*, Tobías Zander, MD* and Manuel Maynar, MD*

* Department of Endovascular Therapy, Hospital Hospiten Rambla, Santa Cruz de Tenerife, Spain
{dagger} Department of Interventional Cardiology, Hospital Hospiten Rambla, Santa Cruz de Tenerife, Spain

Manuscript received December 2, 2009; accepted January 11, 2010.



Figure 1
A 46-year-old female patient was admitted with signs of lower limb ischemia. Her examination demonstrated a nonpalpable distal pulse. Computed tomography angiography revealed an anomalous origin of both renal arteries (A, B) and severe aortic narrowing between the renal arteries, confirmed by the angiogram (C). The diagnosis was middle aortic syndrome (1). Endovascular treatment was decided on, and a balloon-expandable covered stent (Jomed, Abbott Laboratories, Abbott Park, Illinois) was placed, with good stent expansion (D). Physical examination revealed distal pulse recovery. At 5 months, the patient remains asymptomatic. Computed tomography angiography showed stent patency (E, F). Middle aortic syndrome refers to an isolated disease of the thoracoabdominal aorta causing segmental narrowing. It is often associated with hypertension in childhood. This is a rare case of middle aortic syndrome with lower limb ischemia successfully resolved with endovascular treatment.


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1. González-Ferrer JJ, Balbacid E, Vilacosta I. Middle aortic syndrome, severe hypertension, and endovascular repair Eur Heart J 2009;30:1553.[Free Full Text]





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