Purpose or Case Report: Mid-aortic syndrome (MAS) is a rare vascular disorder prevalent in pediatric patients, resulting in narrowing of the abdominal aorta and major branches. Patients who have MAS often suffer from hypertension, organ scarring, and ischemia. We will discuss the case of a 15-year-old male with partial occlusion of his renal arteries and mid aortic artery. This patient was initially treated for hypertension and was diagnosed with MAS after a CT scan presented bilateral renal artery stenosis. His right and left renal arteries were functioning at 40% and 60% capacity respectively, compromising adequate blood flow to his kidneys. This patient was treated through pediatric general surgery in hopes that an angioplasty would return proper blood flow to both his renal arteries, unfortunately it was unsuccessful. He was then referred to pediatric interventional radiology at a second attempt to revascularize the renal arteries and control his hypertension.
We treated this case of Mid-aortic syndrome with a balloon angioplasty for both his renal arteries, with stenting as a backup. Stenting was avoided as it can have long term complications in the pediatric population. The angioplasty was successful and restored function of both kidneys with concomitant improvement of his hypertension. As a result, the patient was able to wean off hypertension medication. This case presents the rare phenomena of managing MAS with renal arterial occlusions and the importance of prompt need to revascularize to avoid long term complications.
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