Thoracoabdominal aorta coarctation with bilateral renal artery involvement: diagnosis with multidetector CT angiography (MDCTA)

Abstract

Atypical coarctation of the descending thoracic and abdominal aorta is a very uncommon vascular disease. Congenital, acquired, inflammatory, and infectious etiologies have been proposed. Patients typically presents with uncontrolled secondary hypertension in the upper half of the body or hypotension in the lower extremities in the first three decades of their lives. We report the case of a 20-year-old man with severe hypertension. Diffuse coarctation of thoracoabdominal aorta associated with bilateral renal artery stenosis was demonstrated clearly by multidetector CT angiography. This is the first case of atypical aortic coarctation diagnosed by MDCTA.

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

“…Patients typically presents with uncontrolled hypertension in the upper half of the body with hypotension in the lower extremeties, visceral ischemia or intermittent claudication in the first decades of life and are at increased risk for coronary, aortic and cerebrovascular events. Longstanding uncontrolled hypertension may cause headache that is often localized to the occipital region and is worse when the patient wakes in the morning and subsides later in the day, dizziness, palpitations, fatigability, epistaxis and blurred vision [23].…”

Severe diffuse hypoplasia of the aorta associated with multiple vascular abnormalities

“…4 Hypoplasia of the aorta that involves both the descending thoracic and abdominal portions is a very uncommon vascular disease, with a great variety of morphological findings. 1,5,12 It is slightly more common among women than men. 5,10 The etiology of aortic hypoplasia is poorly understood.…”

“…3,4 Coarctation of the abdominal aorta is a rare anomaly and accounts for less than 2% of all aortic coarctations. 1,[5][6][7] A much less common malformation is aortic hypoplasia, which comprises tubular hypotrophy of a longer segment of the aorta. 5,8 It has been described in all portions of the thoracic and abdominal aorta.…”

Neonatal Midaortic Syndrome and Renal Artery Atresia Presenting as Malignant Hypertension

“…Involvement of the renal, celiac, and/or superior mesenteric arteries is common [2]. It has been proposed that genetic abnormalities, inflammation, or viral infection may lead to MAS [3,4]. The most common manifestation of MAS is severe systemic arterial hypertension (HTN) and its symptoms (headache, epistaxis, and fatigue) [3,4].…”

“…It has been proposed that genetic abnormalities, inflammation, or viral infection may lead to MAS [3,4]. The most common manifestation of MAS is severe systemic arterial hypertension (HTN) and its symptoms (headache, epistaxis, and fatigue) [3,4]. Treatment of MAS is challenging, and therapies may involve balloon aortoplasty, endovascular stenting, or surgical bypass graft placement [2].…”