Mesenteric Steal Syndrome Caused by Abdominal Aortic Stenosis due to Takayasu Arteritis.

INTRODUCTION

Chronic mesenteric ischemia (CMI) is usually caused by atherosclerotic stenosis of multiple mesenteric arteries. However, aortic stenosis secondary to Takayasu arteritis can rarely cause intestinal ischemia through hemodynamic steal from the mesenteric to lower limb circulation.

CASE PRESENTATION: A 67-year-old woman with a history of Takayasu arteritis presented with postprandial and exertional abdominal pain and a 3-kg weight loss over 2 weeks. CTA revealed isolated severe stenosis of the infrarenal aorta with development of the arc of Riolan, and Doppler ultrasonography demonstrated retrograde flow in the inferior mesenteric artery. Based on these findings, a diagnosis of mesenteric steal syndrome secondary to Takayasu arteritis was made. Endovascular stenting of the infrarenal aorta was performed, resulting in improved antegrade aortic flow and reduced collateral circulation. After treatment, the patient's abdominal pain resolved and her weight recovered.

CONCLUSIONS

This rare case demonstrates that Takayasu arteritis can cause mesenteric steal syndrome without mesenteric arterial lesions and highlights that endovascular stenting can effectively restore physiological blood flow and relieve ischemic symptoms.