What is Leriche syndrome?
Leriche syndrome, also known as aortoiliac occlusive disease, is a type of peripheral arterial disease (PAD). PAD is caused by a buildup of a waxy substance called plaque in your arteries. Arteries are the blood vessels that carry oxygenated, nutrient-rich blood from your heart to the rest of your body. Plaque is made up of fat, calcium, cholesterol, and inflammatory cells. Over time, the buildup of plaque narrows your arteries, making it harder for your blood to flow through them.
Leriche syndrome refers to a buildup of plaque in your iliac arteries. The aorta, the largest blood vessel in your body, branches off around your belly button area into the two iliac arteries. The iliac arteries run through your pelvis and down your legs.
As plaque starts to narrow your iliac arteries, blood flow to your legs may decrease. This can result in a lack of oxygen in your legs, which may cause pain. Over time, you may start noticing other symptoms of Leriche syndrome, including:
- pain, fatigue, or cramping in the legs and buttocks, especially when walking or exercising
- pale, cold legs
- erectile dysfunction
If left untreated, Leriche syndrome may become more serious. Symptoms of advanced Leriche syndrome include:
- extreme pain in the legs or buttocks, even when resting
- numbness in your legs and feet
- sores on your legs or feet that don’t heal
- leg muscle weakness
If you have any symptoms of advanced Leriche syndrome, seek immediate treatment to avoid additional problems, such as gangrene.
The main cause of Leriche syndrome is atherosclerosis, or hardening of the arteries. When plaque builds up in your arteries, they become narrow and hardened. Many things can cause atherosclerosis, including:
- lack of exercise
- poor diet, especially diets that are high in fat
- family history of heart disease
- high blood pressure
- high cholesterol
- older age
While Leriche syndrome is most common in adults over the age of 65, it can also be a cause of erectile dysfunction in younger men. In these cases, erectile dysfunction is usually the only noticeable symptom.
To diagnose Leriche syndrome, your doctor will start with a physical exam. They’ll likely check the pulse points in your legs to evaluate your circulation. You may be asked questions about your lifestyle and family medical history to see if there’s anything that puts you at a higher risk of having Leriche syndrome.
Your doctor may recommend a diagnostic test called the ankle-brachial index (ABI). This involves measuring the blood pressure in your ankle and comparing it to blood pressure in your arm. This can give your doctor a better picture of the circulation of blood in your legs.
Imaging tests, such as a Doppler ultrasound, can also give your doctor a better look at your blood vessels and show any blockages.
If your doctor finds that you do have a blockage, they’ll likely use an arteriogram, sometimes called an angiogram, to see its location and how severe it is. You may receive a magnetic resonance angiogram or a computed tomography angiogram. These imaging tests use either magnetic rays or X-rays to visualize your blood vessels.
Treating Leriche syndrome depends on how severe your case is. In its earlier stages, Leriche syndrome is usually treated with lifestyle changes, such as:
- quitting smoking
- managing high blood pressure
- lowering cholesterol
- managing diabetes, if necessary
- getting regular exercise
- eating a low-fat, high-fiber diet
Your doctor may also prescribe an anticoagulant medication, such as clopidogrel (Plavix), to make it harder for your blood to clot.
More advanced cases of Leriche syndrome may need surgical treatment. Common surgeries for treating Leriche syndrome include:
- Angioplasty: A small tube, called a catheter, with a balloon on the end of it is placed in your blocked artery. When your doctor inflates the balloon, it presses the plaque against the wall of your artery, which helps to open it up. Your doctor may also place a stent to keep the area open as well.
- Bypass: A synthetic tube is used to attach one of your iliac arteries to a blood vessel beyond the blockage. This allows blood to flow through the tube and bypass the blocked part of your artery.
- Endarterectomy: A surgeon opens up the blocked artery and removes the built-up plaque.
The symptoms of advanced Leriche syndrome can lead to several complications. Wounds on your legs or feet that don’t heal are at a high risk of getting infected. If left untreated, gangrene can result in the loss of your leg. Men with advanced Leriche syndrome may also develop permanent erectile dysfunction.
You can reduce your risk of developing Leriche syndrome by following a healthy lifestyle that includes:
- regular exercise
- a diet rich in fruits, vegetables, and whole grains
- managing diabetes, high cholesterol, or high blood pressure
- maintaining a healthy weight
- not smoking
Even if you already have Leriche syndrome, following these lifestyle tips can prevent the disease from getting worse.
While Leriche syndrome can eventually lead to serious complications, it’s easy to manage with lifestyle changes, medication, or surgery. Make sure to tell your doctor about any symptoms you have because Leriche syndrome is much easier to treat in its earlier stages.