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

## TL;DR

A rare case shows that Takayasu arteritis can cause intestinal ischemia through a mesenteric steal syndrome, which was successfully treated with aortic stenting.

## Contribution

This case highlights a novel mechanism of mesenteric steal syndrome caused by aortic stenosis in Takayasu arteritis, without direct mesenteric artery involvement.

## Key findings

- Takayasu arteritis can lead to mesenteric steal syndrome via aortic stenosis.
- Endovascular stenting restored normal blood flow and resolved ischemic symptoms.
- Mesenteric steal can occur without direct mesenteric artery lesions.

## Abstract

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.

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.

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.