Abstract
We report the case of a 56 year-old female patient with multiple cardiac risk factors. At the first medical evaluation the patient presented suggestive symptoms for aortic dissection associated with claudication pain in the lower limbs. Physical examination revealed significant blood pressure asymmetry, systolic heart murmur on the left carotid and subclavian artery, as well as absent pulse in the left radial artery and bilateral femoral arteries. The first electrocardiogram and echocardiography revealed normal values and biologically a moderately high level of blood glucose and lipid profile. The thoraco-abdominal computed tomography angiography infirmed the first diagnostic hypothesis and revealed a quasi-complete left subclavian artery thrombosis, quasi-complete infrarenal abdominal aorta thrombosis extended to the common iliac arteries and also the tight inferior mesenteric artery stenois. Doppler ultrasound of carotid artery and lower limb arterial spindles revealed diffuse atherosclerotic lesion with high significance in the left subclavian artery with the occurrence of the subclavian theft syndrom. The surgical resolution of the main lesion was required so the patient was redirected to the Cardiovascular Surgery Clinic where the aortobifemural bypass was performed using a Dacron prosthetic graft. The presence of multivascular atherosclerotic disease in a female patient with atypical symptoms and fortuitous diagnosis of the main lesion indicated the need for urgent surgical treatment.