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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A cardiac gated CT scan revealed a transverse arch slightly hypoplastic with reduction of the luminal diameter &#40;14 mm&#215;19 mm&#41;&#46; &#8220;Pencil tip&#8221; stenosis of the isthmic area of the aorta without continuity between the two arterial lumens&#46; Collateral circulation&#44; mainly due to the intercostals&#44; internal mammary and epigastric arteries was noted&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 67-year-old male&#44; with a history of hypertension&#44; was investigated for an unquantified weight loss in the previous month&#46; There was reference to an intermittent claudication of the lower limbs with moderate intensity exertion&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">On physical examination there was a discrepancy in the blood pressure &#40;BP&#41; assessed in the upper limbs &#40;BP left arm 160&#47;64 mmHg&#41; and lower limbs &#40;BP left leg 83&#47;59 mmHg&#41;&#46; The physical examination was otherwise unremarkable&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">A cardiac gated computed tomography &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#41; demonstrated a left aortic arch with normal origin of the coronary arteries and supra-aortic branches and a type A interruption of the aortic arch with extensive collateral circulation&#46; An angiography was performed &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>&#41; confirming the absence of continuity between arterial lumens&#46; A transthoracic echocardiogram revealed no cardiac abnormalities&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">A brain magnetic resonance imaging showed three saccular intracranial aneurysms in the superior branch of the middle cerebral artery&#46; The patient underwent surgery with technical success&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">After multidisciplinary meetings&#44; surgical correction was ruled out given the patient&#39;s asymptomatic status&#46; After five years of follow-up the patient remains asymptomatic and properly controlled hypertension&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">An interruption of the aortic arch is a rare presentation of an aortic arch obstruction&#46; It is diagnosed principally in infancy and most patients have associated intracardiac abnormalities and require surgery at a young age&#46; There is a known association between aortic arch abnormalities and intracranial aneurysms&#59; screening may be warranted&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">This case represents a rare presentation of an asymptomatic finding and this patient is&#44; to our knowledge&#44; one of the oldest individuals in whom this condition had been left undiagnosed&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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