LAUSR

A21-year-old male diagnosed with familial hypofibrinogenemia and had multiple admissions for bleeding episodes. He was diagnosed with hypertension at 12 years old and was started on treatment. A computed tomography angiography (CTA) at that time showed a normal diameter of the aorta and no major vascular changes. A recent CTA done when the patient was 21 years old revealed long segment narrowing of the distal thoracic and abdominal aorta, with severe stenosis, at the level of renal artery bifurcation with bilateral renal artery stenosis and significant collaterals within the mesentery, while the aorta above and below was normal in caliber. Hence a diagnosis of middle aortic syndrome (MAS) was made [Figure 1]. MAS is a rare vascular pathology confined to the distal thoracic or abdominal aorta.1 It is characterized by segmental or diffuse narrowing of the aorta or its branches. The majority of the clinical note Oman Medical Journal [2023], Vol. 38, No. 2: e493