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Journal of General and Family Medicine Oct 2017
PubMed: 29264049
DOI: 10.1002/jgf2.63 -
Radiology Case Reports Feb 2024Leriche syndrome is an aortoiliac occlusive arterial disease comprising decreased peripheral pulses, claudication, and erectile dysfunction. We present a case of a...
Leriche syndrome is an aortoiliac occlusive arterial disease comprising decreased peripheral pulses, claudication, and erectile dysfunction. We present a case of a 60-year-old male with abdominal pain and hematochezia who was diagnosed with hemorrhoids. The patient also had associated leg cramps on both sides and lower limb weakness. Further evaluation of the patient with imaging revealed occlusion of the distal descending abdominal aorta below the level of renal arteries and the iliac arteries. An incidental finding of Leriche syndrome was evident. This case report contributes to the current literature when any patient with abdominal pain and bilateral lower limb weakness, Leriche syndrome should be considered to avoid complications as it has high morbidity and mortality.
PubMed: 38044901
DOI: 10.1016/j.radcr.2023.10.077 -
Journal of Atherosclerosis and... Oct 2018We report a case of Tangier disease with Leriche syndrome and bleeding tendency. In this male patient, nasal hemorrhage had been observed frequently throughout...
We report a case of Tangier disease with Leriche syndrome and bleeding tendency. In this male patient, nasal hemorrhage had been observed frequently throughout childhood. At 46 years old, he experienced effort angina, and coronary angiography demonstrated 75% stenosis in the right coronary artery. Orange-colored tonsils, mild hepatosplenomegaly and very low levels of serum high-density lipoprotein cholesterol (HDL-C) were observed, and the patient was diagnosed with Tangier disease. At 52 years old, effort angina recurred. Coronary angiography revealed 75% stenosis of the left main trunk, left anterior descending, and right coronary arteries. Stenosis of the brachiocephalic and right common iliac arteries was also recorded. Stents were implanted, and coronary artery bypass surgery was performed. At 53 years old, 15 months after surgery, the patient reported intermittent claudication, coldness of feet, and impotence. Aortic angiography showed progression of the stenosis at the bifurcation of the common iliac artery. The patient was diagnosed with Leriche syndrome, and aorta-left external iliac artery graft bypass surgery was performed. After surgery, oozing from subcutaneous tissue and leaking from the anastomotic region were observed. Additional analysis revealed two single-nucleotide polymorphisms (V825I and N935T) in the ATP-binding cassette transporter A1 (ABCA1) gene, and accumulation of small dense low-density lipoprotein together with low levels of HDL-C. In Tangier disease, HDL-C is markedly decreased because of ABCA1 deficiency. However, this is the first reported case to exhibit extensive atherosclerosis and bleeding tendency. This patient had atypical extensive and multiple atherosclerotic lesions, accompanied by Leriche syndrome and uncontrollable bleeding.
Topics: Atherosclerosis; Humans; Male; Middle Aged; Prognosis; Severity of Illness Index; Tangier Disease
PubMed: 29563393
DOI: 10.5551/jat.43257 -
Internal Medicine (Tokyo, Japan) Jul 2018
PubMed: 29491301
DOI: 10.2169/internalmedicine.0326-17 -
Clujul Medical (1957) 2016René Leriche (1879-1955) was a 20(th) century French surgeon generally known in medicine for the syndrome that carries his name, namely the Leriche syndrome in the...
René Leriche (1879-1955) was a 20(th) century French surgeon generally known in medicine for the syndrome that carries his name, namely the Leriche syndrome in the aorto-iliac occlusive disease. This paper is published to mark the commemoration of 60 year since Leriche's death. Although Dr. Leriche's legacy resides in the domain of vascular medicine, his research enclosed bone pathology and surgical management of pain. Having his surgical training done under professors Mathieu Jaboulay and Antonin Poncet, his friendship and association with Alexis Carrel and William Halsted have contributed to René Leriche's development as a surgeon, researcher and thinker. Following the footsteps of his mentors, he produced outstanding clinical and academic work which had earned him a good reputation among his students and colleagues. Surgeons such as Jean Kunlin, Jao Cid dos Santos, Michael DeBakey, René Fontaine and others came to study and learn from him. These future generations of surgeons would themselves bring much contribution to the understanding and treatment of vascular diseases and medicine in general. René Leriche pioneered medicine with his research and ideas. His assiduous work of teaching, research and clinical practice made his influence last to our present.
PubMed: 27004042
DOI: 10.15386/cjmed-557 -
Deutsches Arzteblatt International Feb 2022
Topics: Humans; Leriche Syndrome; Arteries
PubMed: 36876412
DOI: 10.3238/arztebl.m2022.0175 -
Neurologia Sep 2020
Topics: Cauda Equina Syndrome; Humans; Intervertebral Disc Displacement; Leriche Syndrome; Polyradiculopathy
PubMed: 30926230
DOI: 10.1016/j.nrl.2018.12.015 -
Interactive Cardiovascular and Thoracic... Jan 2021This study was undertaken to evaluate the acute and midterm results of endovascular treatment with bare metal stents (BMS) for Leriche syndrome patients.
OBJECTIVES
This study was undertaken to evaluate the acute and midterm results of endovascular treatment with bare metal stents (BMS) for Leriche syndrome patients.
METHODS
Patients with Leriche syndrome treated with BMS from August 2008 to May 2017 were included in the study and followed up. The primary endpoints were primary restenosis-free survival rates at 1, 2 and 3 years. The secondary endpoints were secondary restenosis-free and freedom from target lesion revascularization survival rates at 1, 2 and 3 years; technical success rate; complication rate; procedure-related mortality rate; and clinical status improvement at follow-up.
RESULTS
Twenty patients were included and the follow-up duration was 34.7 ± 18.7 months (0-86 months). The 1-, 2- and 3-year primary restenosis-free survival rates were 94.4%, 88.1% and 73.5% and the secondary patency rates were 94.4%, 94.4% and 86.6%, respectively. The freedom from target lesion revascularization survival rates of patients at 1, 2 and 3 years were 94.4%, 88.1% and 79.3%, respectively. The aortoiliac lesions were successfully treated with BMS bilaterally in 17 patients (85.0%) and unilaterally in another 3 patients (15.0%). The complication rate was 10.0% and the procedure-related mortality rate was 0%. Mean ankle-brachial index increased significantly from 0.43 ± 0.20 before the procedure to 0.95 ± 0.21 after the procedure (P < 0.001), and to 1.00 ± 0.19 at the end of the follow-up (P < 0.001). Improvement in symptoms occurred in most patients soon after the endovascular procedure (95.0%) and at follow-up (88.2%).
CONCLUSIONS
Endovascular treatment with BMS is effective and safe for patients with Leriche syndrome according to 3-year follow-up results.
Topics: Aged; Coronary Restenosis; Endovascular Procedures; Female; Follow-Up Studies; Humans; Leriche Syndrome; Male; Metals; Middle Aged; Stents; Survival Analysis; Treatment Outcome
PubMed: 33221834
DOI: 10.1093/icvts/ivaa223 -
Medicina (Kaunas, Lithuania) May 2021Leriche syndrome is an aortoiliac occlusive disease caused by atherosclerotic occlusion. We report a case of Leriche syndrome with a fracture that was suspected as...
INTRODUCTION
Leriche syndrome is an aortoiliac occlusive disease caused by atherosclerotic occlusion. We report a case of Leriche syndrome with a fracture that was suspected as complex regional pain syndrome (CRPS), as the post-traumatic pain gradually worsened in the form of excruciating neuropathic pain.
CASE REPORT
A 52-year-old woman with a history of hypertension was referred to the Department of Pain Medicine from a local orthopedic clinic because of suspected CRPS for excruciating neuropathic pain for one month. She complained of gait dysfunction and severe pain in the right foot following an incident of trauma with the right first toe. The average pain intensity assessed using the visual analog scale (VAS) was 90 (0: no pain, 100: the worst pain imaginable), and the neuropathic pain was evident as a score of 6/10 on Douleur neuropathique 4. Allodynia, hyperalgesia, blue discoloration of the skin, asymmetric temperature change (1.38 °C), and edematous soft tissue changes were observed. Ultrasonography showed a chip fracture in the first distal phalanx of the right first toe. The diagnosis was most probably CRPS type I according to the Budapest research criteria for CRPS. However, multiple pain management techniques were insufficient in controlling the symptoms. A month and a half later, an ankle-brachial index score of less than 0.4 suggested severe peripheral artery disease. Computed tomography angiography showed total occlusion between the infrarenal abdominal aorta and the bilateral common iliac arteries. Therefore, she underwent aortic-bifemoral bypass surgery with a diagnosis of Leriche syndrome. Three months after the surgery, the average pain intensity was graded as 10 on the VAS (0-100), the color of the skin of the right first toe improved and no gait dysfunction was observed.
CONCLUSION
A chip fracture in a region with insufficient blood flow could manifest as excruciating neuropathic pain in Leriche syndrome.
Topics: Aorta, Abdominal; Complex Regional Pain Syndromes; Diagnostic Errors; Female; Humans; Leriche Syndrome; Middle Aged; Neuralgia
PubMed: 34066172
DOI: 10.3390/medicina57050486 -
International Journal of Surgery Case... Sep 2022Leriche syndrome, also known as aortoiliac occlusive disease, is characterized by chronic obstruction of the abdominal aorta and iliac arteries. The disease was first...
INTRODUCTION AND IMPORTANCE
Leriche syndrome, also known as aortoiliac occlusive disease, is characterized by chronic obstruction of the abdominal aorta and iliac arteries. The disease was first described by Robert Graham in 1814. Leriche syndrome was named after a French surgeon, Rene Leriche, who first operated on the condition.
CLINICAL PRESENTATION
We present a 35-year-old male patient who came to our cardiovascular polyclinic in a wheelchair. He had been complaining for a year about severe back pain, leg cramps on both sides, and weakness in both legs. Associated symptoms included fatigue, lower limb tingling, and numbness. Physical examination revealed pulselessness in the popliteal-dorsalis pedis and posterior tibial arteries in both lower extremities, and coldness and ulcers in the dorsum part of the foot.
CLINICAL DISCUSSION
Leriche syndrome often presents with a triad of clinical symptoms: (1) intermittent lower extremity vascular claudication, (2) impotence, and (3) weak/absent femoral pulses. This case report contributes to the current literature when any patient has lower limb weakness, pain, and ulcers. It must be considered in our differential diagnosis list for Leriche syndrome. This makes us more aware of the need for early diagnosis and intervention to decrease late complications of ischemia.
CONCLUSION
Leriche syndrome, also known as aortoiliac occlusive disease, is considered because of its high morbidity and mortality. This was the first case in Somalia to be successfully managed and operated on by using extra-anatomical bypass, especially axillo-bifemoral bypass, by using it as an emergency measure to save ischemic limbs and shorten the length of time in the hospital.
PubMed: 36055171
DOI: 10.1016/j.ijscr.2022.107550