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At least 19 recordsLinked to original sources

Pregnancy and delivery in a patient with aortic prosthesis for Leriche syndrome.

CONTEXT: Leriche syndrome is a thrombotic obliteration of the bifurcation of the aorta, a rare condition that usually affects older men as a result of atherosclerosis. Women of childbearing age rarely need a vascular prosthesis (as a result of Leriche syndrome or other conditions) and there is no literature on an association between Leriche syndrome/vascular prosthesis and pregnancy/labor/delivery. CASE REPORT: A case of pregnancy and delivery in a 38-year-old patient with Leriche syndrome and an aortoiliac prosthesis is presented. The patient had no complications during pregnancy, and was admitted to the maternity hospital when close to term, to begin heparin therapy. Labor ensued spontaneously and a normal vaginal delivery occurred, resulting in a healthy infant. The authors present their considerations regarding the delivery route and the rationale for deciding in favor of vaginal childbirth.

Adult↗

The importance of high lumbar aortography in the Leriche syndrome.

Three patients with Leriche syndrome in whom a conventional low puncture lumbar aortogram failed to demonstrate the causative lesions are described. The aortic obstruction in Leriche syndrome is not always at the lower end of the aorta and may be high in the lumbar aorta. The importance of a high (D12/L1) puncture in patients with suspected Leriche syndrome, so that the whole of the abdominal aorta is visualised, is emphasised.

Adult↗

Coronary artery disease incidence between type II diabetic and non-diabetic patients with Leriche syndrome.

BACKGROUND: Coronary artery disease (CAD) is the major determinant of preoperative morbidity and mortality for patients requiring major vascular surgery. The management of CAD in these patients is controversial. AIMS: The incidence and severity of CAD in diabetic and non-diabetic patients with Leriche syndrome was explored. SETTINGS AND DESIGN: 107 patients with Leriche syndrome were selected as major vascular occlusion and grouped according to their diabetic Status. Sex, age, dyslipidemia, obesity, hypertension, clinic cardiac status, coronary angiographic lesions and coronary revascularisation procedures were noted. MATERIAL & METHODS: Patients' demographics, intra-operative and per-operative data were recorded and compared. In every patient with Leriche syndrome scheduled for elective vascular reconstruction coronary angiography was performed. Lesions were evaluated for the percentages of stenosis. Preliminary coronary bypass or percutaneous coronary intervention was recommended for those found to have advanced or severe CAD. Results of revascularisation procedures were compared. STATISTICAL ANALYSIS USED: Chi-square or Fisher exact chi-square test is used for conditional variables. Independent samples was analysed by using t-test. Kruskal-Wallis variance test was used if the variances are not homogeneous according to the Levene test. RESULTS: No difference was found in both groups except family history and obesity. Coronary angiographic investigation indicates that 59% of DIAB group and 38% of NONDIAB group patients have advanced or severe CAD which has a high probability for myocardial revascularization. Overall revascularisation rate is 37.8% in DIAB group and 45.7% in NONDIAB group (p=0,641). Preoperative mortality was found 2.7% in diabetics and 4.2% in non-diabetics (p=0.342). CONCLUSIONS: Leriche syndrome with diabetes mellitus is more likely to have advanced coronary disease than those without diabetes mellitus. Coronary angiography and subsequent revascularisation should be performed only in those patients who require major vascular surgery.

Adult↗

[The Sudeck-Leriche syndrome as a disturbance in distant regions of the body, clinical picture, and histology (author's transl)].

On the whole, every Sudeck-Leriche syndrome represents a serious complication. The causal noxae are various in nature. In a large case material during a period of observation extending over 26 years a Sudeck-Leriche syndrome was observed as a disturbance in distant regions of the body only in rare cases, for example after herpes zoster, apoplexy, and confusion of the cervical part of the medulla, with cervical and lumbal root irritations, etc. Histological findings in the case of Sudeck-Leriche syndrome are very rarely presented in literature. Histological investigations by the author carried out on muscle tissue in the case of Sudeck-Leriche syndrome yielded remarkable findings with a transition from functional to morphologically irreversible alterations. These alterations were present both in vessels and muscle fibers.

Autonomic Nervous System↗

Leriche syndrome. Surgical procedures and early and late results.

During the past thirteen years, 29 patients underwent surgical intervention for Leriche syndrome. Fifteen patients (aged forty-two to seventy-two years, average 60.7 years) underwent anatomical bypass, and 9 of them whose thrombus was confined to the infrarenal aorta received a routine graft insertion. In the other 6 whose thrombus extended to the level of the renal arteries, an open thrombectomy of the juxtarenal aorta was first performed through a transection of the infrarenal aorta under renal ischemia (4-14 minutes, average 7). Twelve elderly or high-risk patients (aged sixty-eight to eighty-four years, average 75.3 years) underwent an axillobifemoral bypass, and another 2 (fifty-eight and sixty years old, respectively) who had been operated on at an earlier time received an ascending aortobifemoral bypass. In cases of anatomical bypass, no graft has occluded and all patients but 1, who died of cerebral infarction, have an active life now. In cases of extraanatomical bypass, 5 of the 28 grafts occluded and only 6 patients have survived. The other 8 patients died of malignancy, atherosclerotic complications, or unknown causes. The 10-year survival rate was 92.9% and 29.5% in the anatomical bypass and extraanatomical bypass group, respectively. In Leriche syndrome, anatomical bypass is preferred to extraanatomical bypass if conditions permit. In the juxtarenal type, an open thrombectomy under renal ischemia is mandatory for anatomical bypass, and a transection of the infrarenal aorta facilitates this procedure. Because the patients with Leriche syndrome are elderly and harbor arteriosclerotic lesions, a careful follow-up is mandatory.

Adult↗

Modified pudendal thigh flap for perineoscrotal reconstruction: a case of Leriche syndrome with rapidly progressing Fournier's gangrene.

We present the first report of Leriche syndrome associated with Fournier's gangrene. We used a modified pudendal thigh flap in the treatment of an extensive perineoscrotal soft-tissue defect successfully. We propose this new robust flap as an addition to the existing reconstructive armamentarium and draw attention to the coexistence of Leriche syndrome and Fournier's gangrene.

Aortography↗

[Minimally invasive surgery of Leriche syndrome].

Successful treatment of 25 patients with Leriche syndrome with minilaparotomic approach is analyzed. This method promotes a decrease of postoperative complications and faster rehabilitation of patients compared with standard method. Mean time of surgery was 145+/-33,1 min, in one-stage carotid surgery - 182,1+/-27,4 min. Volume of infusion during surgery was 2500 ml, blood loss - 264,6+/-74,4 ml, time of aorta clamping - 24,6+/-5 min. There was no peripheral embolism after surgery. Postoperative lung ventilation lasted for 37,5+/-28,3 min. Mean stay in intensive care unit was 22,5+/-1,97 h. Patients could receive oral nutrition in 28,75+/-7,8 h. The proposed method may be used in the majority of cases as alternative to conventional surgery and doesn't require significant expenditures and expensive equipment.

Aorta, Abdominal↗

Contrast-enhanced MR angiography in patients with aortic occlusion (Leriche syndrome).

The diagnostic utility of contrast-enhanced three-dimensional magnetic resonance angiography (3D MRA) was retrospectively evaluated in 24 patients with Leriche syndrome. 3D MRA was performed either of the abdomen alone (n = 6), the abdomen and chest (n = 2), the abdomen and lower extremities (n = 12), or of all stations (n = 4). MRA image sets were evaluated regarding the location of the aortic occlusion, the presence of concomitant occlusive disease affecting the renal and visceral arteries, the type and extent of collateralization, and the level of the most proximal graftable arterial segments. Intravenous digital subtraction angiography was available for correlation in two patients, while surgical correlation was possible in 14 patients. MRA permitted classification of the level of aortic occlusion as juxtarenal (n = 8), infrarenal, and cranial to the origin of the inferior mesenteric artery (IMA; n = 11), and infrarenal but caudad to the IMA (n = 5). Extraanatomical grafts were displayed to similar advantage as collateral parietal and visceral pathways. Contrast-enhanced 3D MRA thus appears to be well suited for assessment of patients with suspected Leriche syndrome.

Aged↗

Transradial renal artery angioplasty and stenting in a patient with Leriche syndrome.

Percutaneous interventional procedures in the renal arteries are usually performed employing a femoral or brachial vascular access. In contrast, the transradial approach has been established for coronary angiography and angioplasty. We encountered a patient with Leriche syndrome who had renovascular hypertension ascribed to a severe left renal artery stenosis. To stabilize his blood pressure, we made an attempt to relieve the renal artery stenosis with Leriche syndrome by transradial renal artery angioplasty and stenting, using devices for coronary intervention. The procedure was successful without complications or residual stenosis. His hypertension improved with less antihypertensive medications. This case suggests that the radial approach might become an alternative entry site for renal artery interventions.

Angioplasty↗

Renal artery stenosis in a patient with Leriche syndrome: brachial artery access for stent placement.

We encountered a patient with Leriche syndrome and general atherosclerotic disease. His renal function had deteriorated, and diabetic nephropathy was suspected. Severe left renal artery stenosis was also found and considered, if untreated, to be an important factor in aggravation of his renal function. Because the infrarenal abdominal aorta was completely occluded, we treated the patient by insertion of a stent into the left renal artery from the brachial approach. The operation was successful, without residual stenosis or complications. Renal blood flow was remarkably improved after stent placement.

Aorta, Abdominal↗

The Leriche syndrome. A comparative investigation using angiography, computed tomography and ultrasonography.

Nine patients with Leriche syndrome were examined with angiography, computed tomography and routine abdominal ultrasonography. The diagnosis was readily obtained with angiography and computed tomography, while ultrasonography conducted with a linear array real time scanner failed to establish essential features of the disorder. This is mainly because the thrombosed portion of the aorta does not produce any striking alteration of the echo structure of the vessel. Contrast computed tomography defines the abnormalities of the aorta in great detail.

Adult↗

[Acute myocardial infarction complicated by cardiogenic shock in a patient with Leriche syndrome--a case report].

Acute myocardial infarction complicated by cardiogenic shock in a patient with Leriche syndrome - a case report. A 46-year-old male with atherosclerosis obliterans was admitted to the hospital due to chest pain lasting for two hours and signs of cardiogenic shock. ECG revealed postero-inferior myocardial infarction. The patient was successfully treated with primary angioplasty of RCA. Due to atherosclerosis obliterans angioplasty was performed by transulnar approach. After 22 days of treatment and rehabilitation he was discharged home.

Coronary Angiography↗

Nonsurgical aortoplasty in Leriche syndrome.

The abdominal aorta was dilated with a pair of 9-mm balloon catheters in a patient with Leriche syndrome. The bilateral pressure gradient, initially 60 mm Hg, disappeared even after papaverine was injected. Balloon dilatation of the abdominal aorta may be an effective, safe nonsurgical technique, particularly in localized, noncalcified atheromata, and does not carry the risk of impotence seen with surgical endarterectomy or bypass.

Aorta, Abdominal↗

Leriche's syndrome.

Leriche's syndrome will be seen by the podiatric physician, and it can be misinterpreted as pain secondary to mechanical etiology. Often, symptoms of buttock or thigh pain occurring during walking resemble those seen with symptomatic pronation, so this disease entity must be ruled out.

Aged↗