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Leriche syndrome

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Leriche syndrome is a progressive disease that presents as a triad of claudication, erectile dysfunction, and decreased distal pulses.
LS risk factors include: hypertension, diabetes mellitus, hyperlipidemia, and smoking.
Patients may be asymptomatic because of sufficient collateral blood flow.
Symptoms include bilateral buttocks claudication, impotence, leg pain, pallor, and absent femoral pulses.
Differential diagnosis includes: abdominal aortic dissection, neuropathy, spinal canal stenosis, spinal disc herniation, and Guillain-Barré syndrome
Measuring the ankle-brachial index is a noninvasive and part of the evaluation of suspected Leriche syndrome.
Imaging studies with Doppler ultrasonography, aortic angiography, and computed tomographic angiography can aid in confirming the diagnosis and the location of stenosis.
Treatments:  aortobifemoral bypass, aortoiliac endarterectomy, extra-anatomic bypass grafting, and endovascular bypass.
Medical management targets hyperlipidemia, diabetes mellitus, and hyperglycemia, and smoking cessation is also important.
Untreated Leriche syndrome is progressive and results in serious complications.

 

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