Leriche syndrome (Aortoiliac occlusive disease).

An 87‐year‐old 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 ankle‐brachial 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).

Figure 1

An enhanced CT (Panel A) and digital subtraction CT angiography (Panel B) of this patient

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

The patient was admitted to the vascular surgery unit. However, an axillo‐bifemoral bypass procedure was postponed because of his psychiatric problem.

CONFLICT OF INTEREST

The authors have stated explicitly that there are no conflicts of interest in connection with this article.