Leriche syndrome (Aortoiliac occlusive disease)

An 87yearold man presented with recent intermittent claudication in the thighs and calves. Moreover, he complained of bilateral calf and foot pain at midnight. He was a former smoker and had a significant medical history of hypertension, hyperlipidemia, and depression. On physical examination, we found that his dorsal artery pulse was reduced, and he had an anklebrachial index score of 0.4 in both legs. An enhanced abdominal computed tomography (CT) demonstrated abdominal aortic occlusion from the distal abdominal aorta to the bilateral common femoral arteries (Figure 1, panel A), and a digital subtraction CT angiography revealed collateral circulation blood supply to the superficial and deep femoral arteries (Panel B). In 1940, French surgeon and pathologist Leriche, reported a syndrome of thrombotic obliteration of the aortic bifurcation.1 He mentioned that it usually affects young male. However, older and/or female patients have since been reported.2,3 Typical symptoms of Leriche syndrome are intermittent claudication and symptoms related to an arterial insufficiency of the lower extremities, an aggravation of hypertension or newly recognized hypertension, erectile dysfunction, and weight loss.4 A severe decrease in limb perfusion can lead to ischemic rest pain.5 Standard therapy is surgical revascularization including bypass grafts and endarterectomy.4