NASCI case of the month: coral reef thoracic aorta and subclavian artery

Coral reef aorta (CRA) is a rare and severe form of atherosclerotic disease, marked by dense, irregular calcifications that project into the aortic lumen [1]. CRA exhibits an exophytic growth pattern, resulting in pronounced intraluminal obstruction [2]. Mechanisms of CRA are not understood; however, extent of calcification is usually out of proportion to atherosclerosis and probably related to abnormal calcium metabolism and systemic inflammatory state [1]. CRA more commonly affects women, presents with symptoms related to vascular compromise, is often found in the suprarenal and juxtarenal segments of the aorta, and is challenging to treat, often requiring open repair [2, 3].We report a case of CRA involving both the thoracic aorta and subclavian artery, resulting in symptoms of subclavian steal.