The Middle Aortic Syndrome

Obstructive lesions of the aorta and its branches have been the subject of a great deal of interest and study due to the phenomenal growth of vascular surgery in recent years. With this study has come about a constant reappraisal of our clinical knowledge of these cases. Congenital narrowings of the aorta are nearly all located in the isthmial area, and clinical knowledge of these cases is based upon well-recorded and critically documented writings of many workers. The aortic blocks of acquired origin are, however, still the subject of intensive study and within the past decade clearly defined clinical syndromes have been described, depending on the site of the block. The two best known are the aortic arch syndrome of Takayasu (1908), or Martorell and Fabre Tersol (1944) and the terminal aortic (bifurcation) syndrome of Leriche and Morel (1948) (Fig.