Spillenaar Bilgen Reinier A, van der Laan Lijckle, Vos Douwe, Veen Eelco J
Amphia Ziekenhuis, afd. Chirurgie,Breda.
Contact: Reinier A. SpillenaarBilgen (
Ned Tijdschr Geneeskd. 2020 Dec 2;164:D4704.
Leriche syndrome was diagnosed in three patients aged 63, 71 and 73. They presented with a wide range of neurological symptoms such as impotence, pain or dysfunction of the lower extremities. Because a neurological diagnosis was initially suspected, there was a delay in two of the three patients before palpation for a distal pulse in the lower extremities was performed. A pulse was absent in all three patients. Duplex sonography, MR angiography and CT angiography revealed that a pulse was absent due to aortoiliac occlusive disease, also known as Leriche syndrome. They underwent treatment with covered endovascular reconstruction of the aortic bifurcation (CERAB), aortobifemoral bypass or intravenous thrombolysis. All patients significantly improved after treatment. Physicians should always consider aortoiliac occlusive disease in patients who present with neurological symptoms of the lower extremities and must check for a distal pulse in these patients.
三名年龄分别为63岁、71岁和73岁的患者被诊断为勒里什综合征。他们出现了一系列神经症状，如阳痿、下肢疼痛或功能障碍。由于最初怀疑是神经方面的诊断，三名患者中有两名在进行下肢远端脉搏触诊之前出现了延误。三名患者均未触及脉搏。双功超声、磁共振血管造影和CT血管造影显示，由于主髂动脉闭塞性疾病（也称为勒里什综合征）导致脉搏消失。他们接受了主动脉分叉覆膜血管内重建术（CERAB）、主动脉双股动脉旁路移植术或静脉溶栓治疗。所有患者治疗后均有显著改善。医生在遇到出现下肢神经症状的患者时应始终考虑主髂动脉闭塞性疾病，并且必须检查这些患者的远端脉搏。
