LAUSR

The Middle Aortic Syndrome (MAS) is an uncommon clinical expression as a result of isolated stenosis or complete occlusion of the descending thoracic and/or abdominal aorta; Takayasu's Arteritis (TA) is a rare vasculitis and a recognized etiology of MAS. We herein present the case of a 52 year old woman with refractory renovascular hypertension and progressive bilateral lower extremity claudication, she had known history of TA. A Computed Tomography Angiography (CTA) demonstrated an aortic occlusive lesion compromising the origin of the celiac trunk, superior mesenteric and bilateral renal arteries. The patient underwent a complex aortic reconstruction with visceral and renal vessels revascularization utilizing a back table hand-crafted four branched Dacron graft through a left thoracoabdominal approach. The patient recovered uneventfully and was discharged on postoperative day five, and at 36 months from her surgery she remains symptoms-free and without antihypertensive agents.