[The small aorta syndrome]

Area of Science:

• Vascular Surgery
• Radiology
• Cardiovascular Disease

Background:

• Aortoiliac occlusive disease (AIOD) affects arterial supply to the lower limbs.
• Small Aorta Syndrome (SAS) is a less understood variant of AIOD.
• Retrospective analysis of angiograms is crucial for diagnosing vascular conditions.

Purpose of the Study:

• To determine the incidence and characteristics of SAS in patients with AIOD.
• To evaluate the clinical presentation and risk factors associated with SAS in females.
• To assess the outcomes of surgical interventions for SAS.

Main Methods:

• Retrospective analysis of 956 patient angiograms for AIOD.
• Identification of SAS cases based on De Laurentis classification criteria.
• Comparison of angiographic dimensions with operative findings.
• Review of clinical signs, risk factors, and surgical outcomes.

Main Results:

• SAS was identified in 9 female patients (18% of females with AIOD), with a mean age of 41.1 years.
• Common symptoms included claudication (8 pts) and digital gangrene (1 pt).
• Key risk factors were cigarette smoking (100%), hypertension (33%), obesity (25%), and hyperlipidemia (20%).
• Mean aortoiliac dimensions in SAS patients were significantly reduced.
• Eight patients underwent bypass surgery, with a 75% success rate (7/8) at 12.3 months follow-up.

Conclusions:

• Small Aorta Syndrome presents a distinct challenge in female patients with AIOD.
• Early diagnosis and surgical management, particularly bypass grafting, can yield favorable outcomes.
• Further research into the etiology and optimal management of SAS is warranted.