Aortic obstruction: overview of Leriche syndrome

By Cristiano Antonino Last updated Jun 9, 2023

Leriche syndrome is caused by chronic obstruction of the aortic bifurcation and characteristic symptoms include intermittent claudication or symptoms of chronic ischemia, reduced or absent peripheral pulses, and erectile dysfunction

Diagnosis of Leriche syndrome is made by CT scan with contrast medium or magnetic resonance imaging

Abdominal ultrasound is not always able to identify the problem.

However, color Doppler ultrasound may be able to show the absence of vascular flow in the iliac arteries.

However, CT and MRI are always needed for confirmation; to optimize the diagnosis it is useful to undergo arteriography and Doppler examination of the lower limbs.

Clearly, blood tests, arm and ankle pressure measurement to notice the differences between one and the other and any other tests prescribed by the doctor must not be missing.

You may need surgery, or you may proceed with antiplatelet therapy that will help relieve symptoms; other drugs that will be used will be those aimed at improving blood flow and tissue oxygenation.

Compression stockings can be used to support the medical therapy.

More advanced cases of Leriche syndrome may require surgical treatment

Common surgeries to treat Leriche syndrome include: angioplasty, bypass graft, endarterectomy, which involves opening the blocked artery and removing the built-up plaque.

The type of surgery will depend on the severity and location of the lesions: thromboendarterectomy will see the surgical removal of the thrombus occlusion but will only be performed for small lesions located in the aortoiliac tract, in the common femoral artery or in the deep one; revascularization; sympathectomy will see the chemical block of the sympathetic, useful for patients who experience severe pain, but who cannot undergo major surgery; the amputation will be performed in case of uncontrollable pain or gangrene.

At a therapeutic level it is also essential to act on the factors that can trigger atherosclerosis such as: lack of physical exercise, incorrect nutrition with diets excessively rich in fat, obesity, smoking, keeping predisposing diseases such as diabetes mellitus, high cholesterol and systemic hypertension under control.

Prevent Leriche Syndrome

While it is not possible to completely prevent Leriche Syndrome, improving your lifestyle can reduce the likelihood of developing this disease.

Prevention is implemented by doing regular activity, following a diet that is rich in vegetables, fruit, whole grains and reducing fatty foods, not smoking, undergoing periodic checks.

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