Extra-Anatomic Bypass from Ascending Thoracic Aorta to Abdominal Aorta in Takayasu Arteritis with Middle Aortic Syndrome.

Middle aortic syndrome (MAS) is a rare disease causing steno-occlusion of mid-aorta (descending thoracic to abdominal aorta) due to Takayasu arteritis (TAK) [1]. Extraanatomic ascending aorto-abdominal aortic bypass with a prosthetic graft has been reported for the treatment of MAS with TAK [2]. We suggest a new graft pathway thru which graft passes posterior to liver left lobe, through lesser sac, to prevent bowel contact which might cause aortoenteric erosion or fistula [3]. A 23-year-old male was referred to vascular clinic due to uncontrolled hypertension. At the age of 3, he had hypertension due to both renal artery stenoses due to TAK. Repeated angioplasties of renal arteries and aorta were performed, however, despite of multiple medications, hyIm ge of Vacular Srgery Extra-Anatomic Bypass from Ascending Thoracic Aorta to Abdominal Aorta in Takayasu Arteritis with Middle Aortic Syndrome