Understanding Leriche Syndrome

Leriche syndrome is a condition where the patient suffers from three main symptoms:

 Claudication of the buttock area. Claudication refers to pain or cramps that develop with increased walking or exercise 

 Impotence i.e. failure to achieve or maintain an erection in males

 Decreased pulses in the lower limbs

The lower limbs may appear pale and cold.

These symptoms are a result of a block in the lower aorta.

 Blood is carried from the heart to the body via the main artery called the aorta. The aorta moves downwards from the heart to the abdomen. Along its course, it gives out several arteries to supply to different parts of the body. At its end, it divides into two arteries called the common iliac arteries. These arteries supply to the buttock and groin areas, and the lower limbs.

In Leriche syndrome, there is a block in the lower part of the aorta just before the starting point of the common iliac arteries. Thus blood supply to the lower limbs and the groin is reduced.

Conditions that increase clotting of blood raise the risk for Leriche syndrome. These include:

 Increased lipid levels: The excess cholesterol may form plaques in blood vessels and block the flow of blood. A portion of a plaque may separate out and travel along the blood flow, blocking the artery in a narrower portion.

 High blood pressure: High blood pressure damages the walls of blood vessels resulting in deposition of lipids and clot formation.

 Diabetes: Diabetes can cause clot formation via multiple mechanisms.

 Smoking: Smoking enhances clotting of blood.

Imaging studies like the Ankle Brachial Index are used to diagnose Leriche syndrome.

Treatment for Leriche syndrome is usually surgical. A bypass surgery is done to relieve the obstruction. Endoscopic procedures are also being tried out. Other procedures that involve insertion of stent in the artery are also used.

source: MedIndia