A 47-year-old woman presented with a 2-year history of severe proximal claudication symptoms in both legs. Digital subtraction aortography (DSA) showed a localized occlusion of the infrarenal abdominal aorta. A longitudinal arteriotomy and an endarterectomy of the aorta were performed. The arteriotomy was closed with a polytetrafluoroethylene (PTFE) patch. Postoperatively, the follow-up demonstrated a normal aorta with all pedal pulses palpable. In patients with the above symptoms, middle aortic syndrome should be included in the differential diagnosis.
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