Document Type
Article
Publication Date
5-18-2023
Publication Title
Cureus
Keywords
catheter-directed thrombolysis, aortoiliac disease, infrarenal aortic thrombus, limb ischemia, kissing stents, peripheral artery disease, leriche syndrome
ISSN
2168-8184
Volume
15
Issue/No.
5
First Page
e39199
Abstract
Leriche syndrome, a rare and critical complication of peripheral arterial disease (PAD), affects the distal abdominal aorta (infrarenal) and, similar to PAD, is a result of plaque buildup in the arterial lumen. The Leriche syndrome triad includes claudication in the proximal lower extremity, decreased or absent femoral pulses, and, in some cases, impotence. This article presents a patient with an atypical presentation of foot pain who was subsequently found to have Leriche syndrome. The patient was a 59-year-old female, a former smoker, who presented to the emergency department (ED) with atraumatic, acute right foot pain. All right lower extremity pulses were faintly audible on bedside Doppler. Computed tomography with angiography of the abdominal aorta revealed a Leriche-type occlusion of the infrarenal abdominal aorta and left common iliac and a 10 cm right popliteal arterial occlusion. Pharmacological anticoagulation was initiated by the ED. Definitive treatment in this patient included catheter-directed tissue plasminogen activator lysis to the thrombus on the right and placement of kissing stents in the distal aorta without complication. The patient made an excellent recovery and had a complete resolution of her symptoms. PAD is an omnipresent condition and, when untreated, can result in a myriad of high mortality and morbidity conditions such as Leriche syndrome. Collateral vessel formation can make the symptoms of Leriche syndrome vague and inconsistent, often making early recognition difficult. Optimal outcomes hinge on the clinician's ability to efficiently recognize, diagnose, stabilize, and coordinate multidisciplinary involvement of vascular and interventional radiology specialties. Case reports such as this one help to illuminate some of the more infrequent presentations of Leriche syndrome.
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
NSUWorks Citation
Bengio, Moshe; Ta, Quan; Goodwin, Glenn; De Kok, Megan; and Scumpia, Alexander J., "A Patient With Foot Pain Found to Have Leriche Syndrome: A Case Report and Brief Review of the Literature." (2023). HPD Articles. 459.
https://nsuworks.nova.edu/hpd_facarticles/459
DOI
10.7759/cureus.39199
Copyright
© Copyright 2023 Bengio et al.
