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Leriche syndrome
Last reviewed: 23.04.2024
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Lerish syndrome is a symptom complex due to chronic occlusion of the bifurcation of the abdominal aorta and iliac vessels. Distinguish the congenital form caused by hypoplasia of the aorta or fibro-muscular dysplasia of the iliac vessels; and the acquired form, which in 90% of cases is provided by the development of atherosclerosis and in 10% of cases - aortoarteriitis.
[Symptoms of the lerish syndrome
Lerish syndrome clinically, in addition to the symptom of intermittent claudication, cooling and numbness of the lower limbs, hair loss on the legs, slow nail growth, muscle atrophy and malnutrition, impotence often develops.
At palpation there is no pulsation of arteries on the feet, in the popliteal fossa, on the femoral arteries. But with auscultation of the iliac and femoral vessels, systolic murmur is revealed.
Lerish's syndrome has a pathognomonic symptom - lack of pulsation, but the presence of systolic murmur.
Where does it hurt?
What's bothering you?
Stages
Lerish's syndrome and its clinical picture depend on the extent and level of occlusion, as well as on the state of collateral blood flow. At the proximal level, occlusions are divided into 3 options:
- low - below the level of the inferior mesenteric artery;
- average - above the level of the inferior mesenteric artery;
- high - below or at the level of renal vessels.
Depending on the level of distal occlusion, four types are distinguished:
- defeat of the aorta and common iliac;
- defeat of the aorta, common and external iliac;
- to the second type, the superficial femoral artery is additionally affected;
- the vessels of the lower leg are additionally affected.
Lerish's syndrome has 4 degrees of ischemia: I - initial manifestations; IIА - appearance of intermittent claudication after 300-500 m of walking; IIB - the appearance of intermittent claudication after 200 meters of walking; III - pain after 25-50 m walking or at rest; IV - presence of ulcerative necrotic changes.
Diagnostics of the lerish syndrome
Instrumental studies use mainly functional: rheovasography, ultrasound dopplerography, oscillography, plethysmography, etc., in which Lerish syndrome and blood flow in the vessels of the lower extremities will be revealed. Topical diagnosis is carried out by radiopaque aortography, but it is performed only if the question of surgical treatment is raised.