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Leriche Syndrome

Leriche Syndrome is a topic covered in the 5-Minute Clinical Consult.

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Basics

Description

Leriche syndrome, also known as aortoiliac occlusive disease, is caused by atherosclerotic occlusive stenotic disease of the abdominal aorta and iliac arteries, with symptoms of proximal claudication. The hallmark triad of symptoms first reported by René Leriche for whom the syndrome bears his name is erectile dysfunction in males; diminished pulses; and claudication of thighs, hips, or buttocks.

Epidemiology

Incidence
Unknown; however, peripheral artery disease (PAD) increases with advancing age.


Prevalence
  • Prevalence is unknown: 5–10% of patients with PAD
  • Unique triad of symptoms (erectile dysfunction in males, diminished pulses, and claudication of thighs) appears in younger patients between 40 and 60 years, which are younger than for general PAD patients (1).
  • Appears to be more common in males than females

Etiology and Pathophysiology

  • Most common etiology is occlusive plaque in aortoiliac arteries. Cigarette smoking and hypercholesterolemia are two risk factors seen most commonly in patients with occlusive disease.
  • Less likely to be associated with diabetes than typical patterns of PAD
  • Main factors contributing to occlusive disease include arterial wall damage by hypertension, nicotine, lipid accumulation leading to plaque formation, and development of atheroma.
  • A rare cause is Takayasu disease, which is a nonspecific arteritis that can lead to occlusive disease of the aorta.

Genetics
Family history of hypercholesterolemia and PAD

Risk Factors

  • Tobacco use
  • Male gender (1)
  • Hypertension
  • Hypercholesterolemia
  • Family history of PAD

General Prevention

  • Low-fat diet
  • Exercise
  • Low cholesterol
  • Low blood pressure
  • Glycemic control
  • No cigarette smoking

Commonly Associated Conditions

  • Hypertension
  • Coronary artery disease
  • Myocardial infarction
  • Stroke
  • PAD

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Citation

Stephens, Mark B., et al., editors. "Leriche Syndrome." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816303/all/Leriche_Syndrome.
Leriche Syndrome. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816303/all/Leriche_Syndrome. Accessed April 18, 2019.
Leriche Syndrome. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816303/all/Leriche_Syndrome
Leriche Syndrome [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 April 18]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816303/all/Leriche_Syndrome.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Leriche Syndrome ID - 816303 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816303/all/Leriche_Syndrome PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -