Small aorta syndrome.

A 47-year-old female with a 10-year history of bilateral intermittent claudication was diagnosed as having small aorta syndrome (SAS) and was successfully treated by an aorto-bifemoral bypass with aortic thrombendarterectomy. The infra-renal aorta was narrow, being 10 mm in diameter, with thrombotic occlusion of the terminal aorta and common iliac arteries. These findings were compatible with the features of SAS, however, there were few atherosclerotic changes in the abdominal wall and no evidence of any prediposing risk factors such as smoking or hyperlipidemia. Computed tomography, in addition to arteriography, seemed imperative for making the preoperative diagnosis. SAS is not uncommon as an established entity in Western Countries, but in Japan there have been few reports to date. The etiology, diagnosis, and management of this entity are reviewed following the presentation of this case.