Cargando…

A Patient With Foot Pain Found to Have Leriche Syndrome: A Case Report and Brief Review of the Literature

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, decreas...

Descripción completa

Detalles Bibliográficos
Autores principales: Bengio, Moshe, Ta, Quan, Goodwin, Glenn, De Kok, Megan, Scumpia, Alexander J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10276767/
https://www.ncbi.nlm.nih.gov/pubmed/37332424
http://dx.doi.org/10.7759/cureus.39199
_version_ 1785060148221313024
author Bengio, Moshe
Ta, Quan
Goodwin, Glenn
De Kok, Megan
Scumpia, Alexander J
author_facet Bengio, Moshe
Ta, Quan
Goodwin, Glenn
De Kok, Megan
Scumpia, Alexander J
author_sort Bengio, Moshe
collection PubMed
description 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.
format Online
Article
Text
id pubmed-10276767
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Cureus
record_format MEDLINE/PubMed
spelling pubmed-102767672023-06-18 A Patient With Foot Pain Found to Have Leriche Syndrome: A Case Report and Brief Review of the Literature Bengio, Moshe Ta, Quan Goodwin, Glenn De Kok, Megan Scumpia, Alexander J Cureus Emergency Medicine 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. Cureus 2023-05-18 /pmc/articles/PMC10276767/ /pubmed/37332424 http://dx.doi.org/10.7759/cureus.39199 Text en Copyright © 2023, Bengio et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Emergency Medicine
Bengio, Moshe
Ta, Quan
Goodwin, Glenn
De Kok, Megan
Scumpia, Alexander J
A Patient With Foot Pain Found to Have Leriche Syndrome: A Case Report and Brief Review of the Literature
title A Patient With Foot Pain Found to Have Leriche Syndrome: A Case Report and Brief Review of the Literature
title_full A Patient With Foot Pain Found to Have Leriche Syndrome: A Case Report and Brief Review of the Literature
title_fullStr A Patient With Foot Pain Found to Have Leriche Syndrome: A Case Report and Brief Review of the Literature
title_full_unstemmed A Patient With Foot Pain Found to Have Leriche Syndrome: A Case Report and Brief Review of the Literature
title_short A Patient With Foot Pain Found to Have Leriche Syndrome: A Case Report and Brief Review of the Literature
title_sort patient with foot pain found to have leriche syndrome: a case report and brief review of the literature
topic Emergency Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10276767/
https://www.ncbi.nlm.nih.gov/pubmed/37332424
http://dx.doi.org/10.7759/cureus.39199
work_keys_str_mv AT bengiomoshe apatientwithfootpainfoundtohavelerichesyndromeacasereportandbriefreviewoftheliterature
AT taquan apatientwithfootpainfoundtohavelerichesyndromeacasereportandbriefreviewoftheliterature
AT goodwinglenn apatientwithfootpainfoundtohavelerichesyndromeacasereportandbriefreviewoftheliterature
AT dekokmegan apatientwithfootpainfoundtohavelerichesyndromeacasereportandbriefreviewoftheliterature
AT scumpiaalexanderj apatientwithfootpainfoundtohavelerichesyndromeacasereportandbriefreviewoftheliterature
AT bengiomoshe patientwithfootpainfoundtohavelerichesyndromeacasereportandbriefreviewoftheliterature
AT taquan patientwithfootpainfoundtohavelerichesyndromeacasereportandbriefreviewoftheliterature
AT goodwinglenn patientwithfootpainfoundtohavelerichesyndromeacasereportandbriefreviewoftheliterature
AT dekokmegan patientwithfootpainfoundtohavelerichesyndromeacasereportandbriefreviewoftheliterature
AT scumpiaalexanderj patientwithfootpainfoundtohavelerichesyndromeacasereportandbriefreviewoftheliterature