Midaortic Syndrome: A Rare Case in Adulthood

A 25 year old female presented with intermittent claudication at longer distances. Computed tomography angiography revealed aortic coarctation distal to the left subclavian artery (A, arrows) associated with an infrarenal midaortic syndrome with complete occlusion (B, dotted lines). From a narrow aorta emerged a dilated coeliac trunk and the superior mesenteric artery, which through the arc of Riolan (A, arrow points) reperfused the inferior mesenteric artery and distal infrarenal aorta. Since the symptoms did not significantly affect the patient’s quality of life, she was prescribed with supervised exercise therapy. At one year follow up, her symptoms had improved significantly.