Middle Aortic Syndrome: A Case Report and Review of the Literature

Chatzistamatioy, EI

doi:10.17352/2455-5282.000019

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…MAS, also known as aortic coarctation or aortic hypoplasia, may be classified into either suprarenal (70%), infrarenal (7%), or intrarenal (23%) manifestations. 3 Renal and visceral artery involvement is seen in 80% and 22%, respectively, 3 which was not observed in this patient. The average age of diagnosis is 7 years old.…”

Section: Discussionmentioning

confidence: 52%

Surgical management of middle aortic syndrome in an adult

Luu

Pulcrano

Hua

2020

Journal of Vascular Surgery Cases, Innovations and Techniques

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Middle aortic syndrome (MAS), a coarctation of the lower thoracic and/or abdominal aorta, is typically diagnosed and treated in the pediatric population. We present a 48-year-old patient with a long-standing history of hypertension who was lost to follow-up owing to a lack of insurance coverage. After two myocardial infarcts owing to severe hypertension, a vascular workup including a computed tomography angiogram revealed a diagnosis of MAS. He underwent open vascular reconstruction with a thoracoabdominal Dacron bypass graft. He was discharged within 1 week with no hypertension or claudication. Adult patients diagnosed with MAS should undergo open or endovascular surgical repair with close follow-up.

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Section: Discussionmentioning

confidence: 52%

Surgical management of middle aortic syndrome in an adult

Luu

Pulcrano

Hua

2020

Journal of Vascular Surgery Cases, Innovations and Techniques

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“…The coarctation may be several centimetres long or short and 'web-like'. 5 A systematic review of the middle aortic syndrome in children found 64% to be idiopathic, 15% to be genetic (including neurofibromatosis and William's syndrome), 17% to be inflammatory (such as Takayasu's disease) and 4% due to fibromuscular dysplasia. 6 The morphology was not reported in 62% of patients in this systematic review, but of those in whom the morphology was available, 60% had a discrete segmental narrowing (some of which may have resulted in a web-like appearance).…”

mentioning

confidence: 99%

Aortic webs and cobwebs: Aortic dissection and arteriopathies

et al. 2018

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In aortic dissection, differentiating the true and false lumen can often be difficult but is crucial for planning endovascular management. The 'aortic cobwebs' sign is a helpful anatomic marker for the false lumen, appearing as thin linear filling defects bridging across the false lumen on contrast enhanced CT ( Fig. 1). Pathologic correlation by Williams et al. 1994 suggests these 'cobwebs' represent residual ribbons of incompletely sheared media. 1 This sign has also been reported on MRI and US. 2 Further studies have demonstrated this sign is a specific but relatively insensitive indicator of the false lumen in aortic dissection. 3 Various stenoses in the arteries have been described as webs or web-like. These have also been reported in the aorta, although are more common in smaller vessels.Coarctation typically occurs in the aorta just distal to the left subclavian artery. 0.5-2% occur in the distal descending or abdominal aorta where they present as the 'middle aortic syndrome'. The coarctation may be several centimetres long or short and 'web-like'. 5 A systematic review of the middle aortic syndrome in children found 64% to be idiopathic, 15% to be genetic (including neurofibromatosis and William's syndrome), 17% to be inflammatory (such as Takayasu's disease) and 4% due to fibromuscular dysplasia. 6 The morphology was not reported in 62% of patients in this systematic review, but of those in whom the Fig. 1 Aortic Cobweb -Axial view of CT Aortogram demonstrating cobwebs within the false lumen of the aortic arch in a Stanford A aortic dissection.Fig. 2 Aortic Web -Coronal and Sagittal views of CT Aortogram demonstrating a web (arrow) in the descending thoracic aorta in patient under investigation for chest pain. The aorta was otherwise normal and the provisional diagnosis in this patient is an intraluminal thrombus.

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Mid-aortic syndrome presenting in adulthood: A case report and review of the literature

Whipple,

Craswell

2024

Journal of Vascular Nursing

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Middle Aortic Syndrome: A Case Report and Review of the Literature

Cited by 3 publications

References 17 publications

Surgical management of middle aortic syndrome in an adult

Surgical management of middle aortic syndrome in an adult

Aortic webs and cobwebs: Aortic dissection and arteriopathies

Mid-aortic syndrome presenting in adulthood: A case report and review of the literature

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