Calcified obstructive disease of the aortic arch.

Coral reef aorta is described as rock-hard calcifications usually localized in the visceral part of the aorta. Rare cases of acquired coarctation of the descending aorta due to coral reefs have been mentioned in the literature. A more uncommon entity is the coral reef of the aortic arch. We are presenting a rare case of a 55-year old woman referred to our vascular department for bilateral lower limb claudication associated with resistant hypertension and anisotension. A thoracoabdominal computed tomography scan was subsequently performed and showed a preocclusive calcified lesion located at the termination of the aortic arch, involving the ostia of the left subclavian artery. An open surgical approach was decided upon and an aortic endarterectomy by transversal aortotomy was successfully performed. Although uncommon, acquired coarctation should be considered in all hypertensive patients presenting with bilateral lower limb claudication and blood pressure differences between the upper and lower extremities.