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Cleveland Clinic Journal of Medicine Sep 2021
Topics: Humans; Leriche Syndrome
PubMed: 34470750
DOI: 10.3949/ccjm.88a.20179 -
Aorta (Stamford, Conn.) Apr 2022Leriche syndrome is characterized by abdominal aorta and/or bilateral iliac occlusive disease, with a triad of clinical symptoms and signs such as claudication, erectile...
Leriche syndrome is characterized by abdominal aorta and/or bilateral iliac occlusive disease, with a triad of clinical symptoms and signs such as claudication, erectile dysfunction, and decreased distal pulses. Diagnostic imaging is one of the key factors for diagnosis of the anatomic origin of the Leriche symptoms. We report the case of a 56-year-old man with diagnosis of abdominal aorta and bilateral iliac occlusive disease with a wide collateral vascular network.
PubMed: 35654436
DOI: 10.1055/s-0041-1729918 -
Agri : Agri (Algoloji) Dernegi'nin... Jan 2017Leriche syndrome is a disease characterized by thrombotic occlusion in the aorta, frequently in the distal renal artery. Classic symptoms of this syndrome include pain...
Leriche syndrome is a disease characterized by thrombotic occlusion in the aorta, frequently in the distal renal artery. Classic symptoms of this syndrome include pain in the lower extremities emerging during activity (claudication), impalpability of femoral pulses, and impotency in male patients. Definitive diagnosis of claudication due to insufficient circulation as well as claudication that is neurogenic in origin, is difficult. Medical history, physical examination, and monitoring methods are important for definitive diagnosis. Impalpability of bilateral femoral pulses in physical examination may be sign of Leriche syndrome. Color Doppler ultrasonography can be used to demonstrate that there is no circulation in the iliac arteries in cases of Leriche syndrome. In these patients, thrombotic occlusion of the aorta is confirmed by computed tomography angiography. Presently described is a case of Leriche syndrome in which the patient presented at hospital with complaint of claudication and was diagnosed with lumbar disc herniation. Since vascular pathologies were not considered in differential diagnosis, treatment was delayed and it resulted in mortality; for this reason it is important. When patients come to hospital with complaints of leg pain, clinicians should consider vascular pathologies before reaching definitive diagnosis, using detailed patient history and comprehensive physical examination.
Topics: Diagnosis, Differential; Humans; Intermittent Claudication; Leriche Syndrome; Male; Middle Aged; Pain Measurement; Tomography, X-Ray Computed
PubMed: 28467568
DOI: 10.5505/agri.2015.65983 -
Turkish Journal of Obstetrics and... Mar 2020Leriche's syndrome is characterized by chronic obstruction of the abdominal aorta and iliac arteries. A patient with Leriche's syndrome presented with twin pregnancy and...
Leriche's syndrome is characterized by chronic obstruction of the abdominal aorta and iliac arteries. A patient with Leriche's syndrome presented with twin pregnancy and severe preeclampsia at 32 weeks' gestation. Cesarean delivery was performed and the patient was admitted to the intensive care unit. Magnetic resonance angiography showed total occlusion of the distal abdominal aorta, common, and external iliac arteries. There were extensive collateral vessels between the lumbar arteries and iliolumbar arteries. The patient was discharged in an improved clinical condition. Leriche's syndrome and pregnancy demonstrating complete aortic, common, and external iliac artery occlusion is very rare in the literature. Despite complete occlusion, viability of the fetus can be achieved with collateral vessels.
PubMed: 32341833
DOI: 10.4274/tjod.galenos.2019.58219 -
Journal of Clinical and Translational... Aug 2022Some transcatheter aortic valve implantation (TAVI) candidates present with ubiquitary arterial disease with massive calcification burden and stenoses in the whole...
BACKGROUND AND AIM
Some transcatheter aortic valve implantation (TAVI) candidates present with ubiquitary arterial disease with massive calcification burden and stenoses in the whole arterial tree and cannot undergo any transvascular TAVI-approach. Moreover, a history of previous coronary surgery including LIMA-LITA bypass grafting, previous carotid surgery or stenosis/occlusions, a concomitant porcelain aorta, Leriche syndrome, diverse other aortic diseases, arterial occlusions, or a chronic dialysis with arteriovenous shunt are common in such patients with end-stage peripheral artery disease, making even a minimal artery access impossible. For patients without arterial access or at very high risk for artery injury, we modified the transapical-TAVI method to ensure artery-no-touch-technique. We employed this technique in six patients without procedural and in-hospital complications.
RELEVANCE FOR PATIENTS
A high-grade aortic stenosis is a serious disease. Untreated patients exhibit poor survival. Only surgery or TAVI is valid therapy concept for treatment. However, some patients can undergo neither surgery nor TAVI, because of an extensive surgical risk or inoperability, whereas at the same time, no arterial approaches are available due to extensive, end-stage panarteriopathy. For these high-specific patients, our modified, artery-no-touch-TA-TAVI is an appropriate method and can be safely used.
PubMed: 35991081
DOI: No ID Found -
International Journal of Emergency... Feb 2022Leriche syndrome is caused by atherosclerosis and is often characterized by symptoms such as intermittent claudication and numbness and coldness of the lower limbs. Its...
BACKGROUND
Leriche syndrome is caused by atherosclerosis and is often characterized by symptoms such as intermittent claudication and numbness and coldness of the lower limbs. Its exact prevalence and incidence are unknown because it is a rare disease. We report a case of Leriche syndrome diagnosed incidentally on trauma pan-scan computed tomography (CT).
CASE PRESENTATION
A 61-year-old Asian male was driving a passenger car and had a head-on collision with a dump truck that required an emergency call. The patient was transported to our hospital in a doctor's helicopter. Physical examination revealed the following vital signs: respiratory rate, 23 breaths per min; SpO, 98% under a 10-L administration mask; pulse rate, 133 beats per min; blood pressure, 142/128 mmHg; Focused Assessment with Sonography for Trauma, positive; Glasgow Coma Scale assessment, E3V5M6; and body temperature, 35.9 °C. Trauma pan-scan CT showed bilateral mandibular fractures, bilateral multiple rib fractures, bilateral pneumothorax, sternal fractures, hematoma around thoracic spine, small bowel perforation, mesenteric injury, right clavicle fracture, right ankle debridement injury, and thrombotic occlusion from just above the abdominal aortic bifurcation to the bilateral common iliac arteries. Although thrombotic occlusion needed to be differentiated from traumatic aortic injury, the presence of collateral blood vessels led to the diagnosis of Leriche syndrome, and conservative treatment was performed. Damage control surgery was required for the small bowel injuries. From the second day of admission, the patient was treated with continuous intravenous heparin and prostaglandin preparations. However, impaired blood flow and reperfusion injury in the right lower extremity progressed. On the fifth day of admission, right thigh amputation was performed. The patient required renal replacement therapy for 2 weeks starting from the third day of admission.
CONCLUSIONS
In this case, conservative therapy was initially chosen for Leriche syndrome. However, the complex factors in the acute phase of trauma led to development of hemorrhagic necrosis, requiring amputation of the lower extremity. Our findings indicate the need to carefully consider the unique factors affecting Leriche syndrome patients when considering treatment indications and choices for trauma.
PubMed: 35120433
DOI: 10.1186/s12245-022-00411-x -
International Journal of Environmental... Mar 2022: Recovery of normal arterial inflow in the lower limbs after Leriche's syndrome surgery does not always improve erection. This study assesses the effects of Leriche...
: Recovery of normal arterial inflow in the lower limbs after Leriche's syndrome surgery does not always improve erection. This study assesses the effects of Leriche syndrome on erectile and ejaculatory dysfunction in patients awaiting surgical treatment and the impact of treatment used on sexual dysfunctions. : 35 men with Leriche syndrome aged 61.3 years (SD = 7.74) were assessed for erectile dysfunction. The patients were classified into three groups: aortofemoral bypass (group 1); stenting of the iliac artery (group 2) and aortobifemoral bypass (group 3). The patients were qualified for surgery based on the TASC II guidelines. Follow-up was done 3 months after treatment. : The mean preoperative IIEF-5 score was 14. 69 (+/- 5.30), with better preoperative scores obtained by 54.3% of patients. A total of 51.4% and 48.6% of patients, respectively, reported normal erection enabling satisfactory penetration and normal ejaculation before treatment. After surgical treatment, satisfactory erection was reported by 60% of all surgically treated patients, whereas the presence of ejaculation was reported by only 14.2% of patients. The IIEF-5 score is a tool for careful assessment of vascular erectile dysfunctions, it allows for the evaluation of erectile dysfunctions in relation to atherosclerosis risk factors. The treatment strategy used allowed for slight improvement as evidenced to erection but decreasing normal ejaculation.
Topics: Erectile Dysfunction; Humans; Leriche Syndrome; Male; Penile Erection; Pilot Projects; Prospective Studies; Sexual Dysfunction, Physiological
PubMed: 35270783
DOI: 10.3390/ijerph19053091 -
Journal of Acute Medicine Jun 2018Lower extremity weakness is a neurological symptom that can be caused by several factors, including cerebrovascular accident, spinal cord disease, peripheral nerve...
Lower extremity weakness is a neurological symptom that can be caused by several factors, including cerebrovascular accident, spinal cord disease, peripheral nerve disease, neuromuscular junction disease, muscle disease, or other metabolic conditions, such as hypoglycemia and hypokalemia. However, vascular occlusive disease may exhibit neurological symptoms. Here, we present a case of aortoiliac artery total occlusion, Leriche syndrome.
PubMed: 32995207
DOI: 10.6705/j.jacme.201806_8(2).0006