Abstract
We operated on two cases of small aorta syndrome (SAS). Case 1 was a 43-year-old man who complained of pain and cyanosis of the left first and second toes and was admitted to our department. Angiography showed narrowing of the infra-renal aorta, 11mm in diameter just above the bifurcation. It also showed stenosis of the right external iliac artery and occlusion of the left external iliac artery. Aorto-bifemoral bypass, using a 12×6mm bifurcated knitted Dacron graft, was performed without incident. Case 2 was a 21-year-old man. He was admitted with a chief complaint of intermittent claudication of his left calf. Angiography showed narrowing of the infra-renal aorta, 12mm in diameter just above the bifurcation. It also showed occlusion of the left superficial femoral artery. A femoro-popliteal bypass, using a 6mm knitted Dacron graft, was successfully performed. Both cases were diagnosed as SAS. In the literature, SAS is characterized by narrowing of the infra-renal aorta and is frequently accompanied by hypoplasia of the iliac arteries. Although SAS is not uncommon in Western countries, there are only a few reports in Japan. SAS has been reported more frequently in women with a relatively early age of onset. The graft patency rate in these patients is observed to be much less than that in the general population of patients who require aortoiliac reconstruction. Therefore, long-term follow-up is important to observe possible deterioration of ischemic symptoms and signs in SAS patients even after apparently curative operations.
