Treatment Strategy for Leriche Syndrome Complicated with Ischemic Heart Disease

Jun Hayashi＊	Tetsuro Uchida＊	Yoshinori Kuroda＊
Eiichi Ohba＊	Masahiro Mizumoto＊	Atsushi Yamashita＊
Shingo Nakai＊	Kimihiro Kobayashi＊	Tomonori Ochiai＊

（Second Department of Surgery, Faculty of Medicine, Yamagata University＊, Yamagata, Japan）

Leriche syndrome is often complicated with ischemic heart disease（IHD). In such cases, as the internal mammary artery（IMA）supplies blood to the lower-limbs through a collateral network, coronary artery bypass grafting（CABG）using IMA is considered to worsen the lower-limb ischemia and use of intra-aortic balloon pumping prior to lower limb revascularization is not possible. Recent advances in endovascular technology enable us to perform endovascular treatment（EVT）even in Leriche syndrome. In 3 patients diagnosed with Leriche syndrome associated with IHD, tailor-made treatments were performed as one-stage or two-stage surgeries. Various techniques such as percutaneous coronary intervention（PCI), CABG, and open surgical revascularization or EVT of lower limbs were employed. EVT is a less invasive and more attractive alternative to open surgical revascularization, it led to new treatment options in patients with this particular circumstance. Considering the severity of pathophysiology, treatment strategy should be determined on a case-by-case basis.

 

Jpn. J. Cardiovasc. Surg. 50:283-286（2021）

Keywords：Leriche syndrome;aortoiliac occlusive disease;endovascular treatment;ischemic heart disease;coronary artery bypass grafting