Segmental aortic occlusion: An unusual lesion found in menopausal women

A subgroup of patients with aortoiliac atherosclerosis are perimenopausal women in whom the lesions are confined to the midportion of the terminal aorta. The lesions occur in relatively small, though not hypoplastic, vessels, and it is speculated that the relatively small size of the terminal aorta functions as a long stenosis with resultant predisposition to atheroma formation. Other etiologic factors are not identified except for smoking. Endarterectomy results in satisfactory restoration of distal arterial flow. Recurrence has not been observed but the question exists as to whether replacement of the small segment with a larger prosthesis may be more appropriate in view of the possible etiology described.