Thoracoabdominal aortic aneurysm accompanied by Leriche syndrome is an extremely rare combination of aortic diseases, the surgical management of which has not been described to date. We report the successful treatment of one such case through open surgical repair of the thoracoabdominal aorta.
Aorta ; Aortic Aneurysm, Thoracic* ; Aortic Diseases ; Arterial Occlusive Diseases ; Blood Coagulation Disorders ; Leriche Syndrome* ; Thrombosis

The syndrome of aortoiliac occlusive disease, also known as Leriche syndrome, is characterized by claudication, pain, and diminished femoral pulse. We highlight an unusual case of right sciatic neuropathy caused by Leriche syndrome, which was initially misdiagnosed. A 52-year-old male, with a past medical history of hypertension and bony fusion of the thoracolumbar spine, visited our hospital complaining of right leg pain and claudication, and was initially diagnosed with spinal stenosis. The following electrophysiologic findings showed right sciatic neuropathy; but his symptom was not relieved, despite medications for neuropathy. A computed tomography angiography of the lower extremities revealed the occlusion of the infrarenal abdominal aorta, and bilateral common iliac and right external iliac arteries. All these findings suggested omitted sciatic neuropathy associated with Leriche syndrome, and the patient underwent a bilateral axillo-femoral and femoro-femoral bypass graft.
Angiography ; Aorta, Abdominal ; Humans ; Hypertension ; Iliac Artery ; Leg ; Leriche Syndrome* ; Lower Extremity ; Male ; Middle Aged ; Sciatic Neuropathy* ; Spinal Stenosis ; Spine ; Transplants

Chronic atherosclerotic occlusion of the abdominal aorta is a rare disease in clinical practice. In this disease, juxtarenal aortic occlusion is defined as the condition extended, adjacent to the renal arteries. The treatment of juxtarenal aortic occlusion is more difficult than a 'simple' abdominal aortic occlusion. Vascular surgery of a juxtarenal aortic occlusion-specifically aortic endarterectomy and bypass grafting-is a challenging procedure that almost invariably requires aortic cross-clamping above the level of the renal arteries, and may be associated with significant morbidity and mortality. With the advent of endovascular treatment, percutaneous transluminal angioplasty and stent implantation have been used increasingly as an alternative to conventional surgery in the management of patients with aortoiliac disease. However, endovascular treatment for juxtarenal aortic occlusion is not common and, also, special attention is needed with regard to possible renal complications. Here, we report the successful revascularization of a case of chronic juxtarenal aortic occlusion with endovascular treatment and adjunctive anticoagulation.
Angioplasty ; Aorta, Abdominal ; Endarterectomy ; Endovascular Procedures ; Humans ; Leriche Syndrome ; Rare Diseases ; Renal Artery ; Stents

No abstract available.
Leriche Syndrome

PURPOSE: Most outcome studies of bypass surgery are limited to five years of follow-up. However, as human life expectancy has increased, analyses of more long-term outcomes are needed. The aim of this study is to evaluate 10-year outcomes of anatomical bypasses in aortoiliac occlusive disease. METHODS: From 1996 to 2009, 92 patients (82 males and 10 females) underwent aortic anatomical bypasses to treat aortoiliac occlusive disease at Samsung Medical Center. The patients were reviewed retrospectively. Kaplan-Meier survival analyses were performed using PASW ver. 18.0 (IBM Co). RESULTS: A total of 72 patients (78.3%) underwent aorto-femoral bypasses (uni- or bi-femoral), 15 patients (16.3%) underwent aorto-iliac bypasses (uni- or bi-iliac), and 5 patients (5.4%) underwent aorto-iliac and aorto-femoral bypasses. The overall primary patency rates of the 92 patients were 86.2% over 5 years and 77.6% over 10 years. The 10-year limb salvage rate and overall survival rate were 97.7% and 91.7%, respectively. CONCLUSION: The overall patency rates of bypass graft and limb salvage rates decreased as time passed. The analysis of results after bypass surgery to treat arterial occlusive disease will be needed to extend for 10 years of follow-up.
Arterial Occlusive Diseases ; Follow-Up Studies ; Humans ; Leriche Syndrome ; Life Expectancy ; Limb Salvage ; Male ; Outcome Assessment (Health Care) ; Retrospective Studies ; Survival Rate ; Transplants

Child, Preschool ; Heart Septal Defects, Ventricular ; complications ; Humans ; Leriche Syndrome ; complications ; Male

Extra-anatomic graft bypass is frequently performed instead of standard infrarenal aorto-iliac reconstruction in patients with Leriche syndrome in whom the thrombus extends to the level of the renal arteries. However, many different surgical options are still being attempted due to the unsatisfying long-term graft patency. We performed a descending thoracic aorto-bifemoral bypass graft with 14 and 14-7-7 mm artificial vessels through a posterolateral thoracotomy, a median laparotomy, and a longitudinal inguinal incision in a 48-year-old male who suffered from claudication with Leriche syndrome. After surgery, the patient recovered well and was discharged. The patient walked well without any symptoms during the 6 month follow-up period in the outpatient department. We have concluded that descending thoracic aorto-bifemoral bypass grafting could be considered as an alternative method for patients with Leriche syndrome in whom standard infrarenal aorto-iliac reconstruction is unsuitable.
Arterial Occlusive Diseases ; Arteries ; Follow-Up Studies ; Humans ; Laparotomy ; Leriche Syndrome ; Male ; Middle Aged ; Outpatients ; Renal Artery ; Thoracotomy ; Thrombosis ; Transplants

We report a case of renovascular hypertension (RVH) by severe left renal artery stenosis (RAS) that was successfully treated by percutaneous intervention in a single-kidney patient with Leriches syndrome. A 51-year-old man was admitted to our hospital due to uncontrolled hypertension on medications with maximal doses. CT angiography showed complete occlusion of the infrarenal abdominal aorta, the absence of the right kidney and the approximately 80% stenosis of the proximal left renal artery. The proximal left RAS was considered as an important factor in uncontrolled secondary hypertension and aggravation of his renal function. We made an attempt to relieve the RAS by transaxillary renal artery angioplasty and stenting because of the total occlusion of the bilateral iliac artery. His renal function was remarkably improved and his hypertension was well controlled with less antihypertensive medications after the procedure.
Angiography ; Angioplasty* ; Aorta, Abdominal ; Constriction, Pathologic ; Humans ; Hypertension ; Hypertension, Renovascular ; Iliac Artery ; Kidney ; Leriche Syndrome* ; Middle Aged ; Renal Artery Obstruction ; Renal Artery* ; Stents*

Leriche syndrome is an aortoiliac occlusive disease. The aortoiliac junction is the most common sites of chronic obliterative atherosclerosis. Leriche syndrome has a variety of clinical symptoms attributed to the obstruction of the infrarenal aorta. Common clinical symptoms include thigh, hip, and buttock claudication as well as erectile impotence, usually in association with diminished femoral pulses. But acute anuric renal failure as first manifestation of Leriche syndrome is very uncommon. Contrast-enhanced 3D MRA appears to be well suited for assessment of patients with suspected Leriche syndrome. We report a 75-year-old man who presents anuria as first manifestation of Leriche syndrome.
Acute Kidney Injury ; Aged ; Anuria* ; Aorta ; Atherosclerosis ; Buttocks ; Erectile Dysfunction ; Hip ; Humans ; Leriche Syndrome* ; Male ; Renal Insufficiency ; Thigh

There was no significant difference in morbidity and mortality between those that received simultaneous operation for coronary artery disease and peripheral vascular disease versus those that received coronary artery bypass graft alone. Simultaneous operation is also cost effective. A 46 year-old patient with resting chest pain and intermittent claudication was diagnosed as unstable angina and Leriche's syndrome. We performed simultaneous revascularization for coronary artery stenosis with internal mammary artery and right gastroepiploic artery and a bifurcated vascular graft interposition between in the aorta, left common iliac and right femoral arteries for Leriche's syndrome. The postoperative coronary angiogram and aortogram revealed a good patency of the arterial conduits and vascular graft. He has been followed for 12 months without any problem.
Angina, Unstable ; Aorta ; Chest Pain ; Coronary Artery Bypass ; Coronary Artery Disease ; Coronary Stenosis* ; Coronary Vessels* ; Femoral Artery ; Gastroepiploic Artery ; Humans ; Intermittent Claudication ; Leriche Syndrome ; Mammary Arteries ; Middle Aged ; Mortality ; Peripheral Vascular Diseases* ; Transplants