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Acute Bilateral Lower Limb Ischemia Mimicking Neurological Emergency: A Case of Leriche Syndrome

Year: 2025

Type: article

Abstract: Leriche syndrome, a rare manifestation of chronic aorto-iliac occlusive disease, may occasionally present acutely with bilateral lower limb ischemia, mimicking neurological emergencies such as cauda equina syndrome. We report a 70-year-old man presenting with sudden-onset bilateral lower limb weakness and numbness. Examination revealed cold, pulseless lower limbs. CT angiography demonstrated extensive thrombosis from the descending thoracic aorta to the iliac arteries, with complete occlusion of the right superficial femoral artery. The patient underwent urgent open embolectomy of the femoral and subclavian arteries, aorto-bifemoral bypass via axillary artery anastomoses, and bilateral lower limb fasciotomies. Although perfusion was successfully restored in the left lower limb, irreversible ischemia in the right leg necessitated an above-knee amputation. This case highlights the importance of early recognition of acute aorto-iliac thrombosis, rapid vascular imaging, and coordinated multidisciplinary intervention to optimize outcomes in this rare yet critical vascular emergency.

Source: Cureus

DOI: 10.7759/cureus.96397

Authors: Bharath Sundaramoorthy, Muthusankar Sudalaimuthu, Suresh Kumar Gopala Pillai

Institutions: Government Medical College Thoothukudi, Swansea Bay University Health Board, Morriston Hospital

Language: English

Topic: Peripheral Artery Disease Management

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4416058938