It can occur in major arteries throughout the body, commonly seen in the lower part of the abdominal aorta and the large and medium arteries of the lower limbs. The condition involving the abdominal aorta below the renal arteries and both common iliac arteries is called Leriche syndrome.

bubble_chart Diagnosis

1. The onset is mostly in people over 50 years old, and it is more common in males. It is often accompanied by hypertension, hyperlipidemia, retinal {|###|} arteriosclerosis, coronary heart disease, or diabetes.

2. In the early stage, the affected limb may feel cold, numb, and easily fatigued, with intermittent claudication. In the late stage [third stage], there may be rest pain in the toes or foot. The affected limb may exhibit nutritional disorders, pale skin, decreased skin temperature, reduced sensation, thickened and deformed toenails. A systolic murmur may be heard along the {|###|} arterial pathway, and the pulse distal to the lesion may weaken or disappear. In severe cases, gangrene, ulcers, and muscle atrophy may occur.

3. Segmental limb pressure measurement, {|###|} waveform analysis, and transcutaneous oxygen pressure testing can help determine the location and severity of {|###|} occlusion. If necessary, seasonal epidemic {|###|} angiography may be performed.

bubble_chart Treatment Measures

1. Non-surgical therapy

includes dietary control, appropriate exercise, smoking cessation, keeping warm; application of lipid-lowering drugs, vasodilators, and Chinese medicine; limb negative pressure therapy, etc. The above treatments can also be used before and after surgery.

2. Surgical therapy

Depending on the location, severity, extent of the lesion, and collateral circulation, the following surgical methods may be selected:

Using artificial blood vessels or autologous veins, a bridge-type end-to-side anastomosis is performed at the proximal and distal ends of the occluded stirred pulse to reconstruct blood flow. It can be divided into anatomical bypass (located near the lesion) and non-anatomical bypass (far from the lesion). The former is commonly used, while the latter is only applied in cases of local infection or when the patient cannot tolerate laparotomy or thoracotomy.

(2) Stirred pulse intimal stripping

Suitable for stirred pulses with short lesion ranges and moderate or higher severity, provided the distal end is patent.

(3) Membrane grafting.

(4) Venous stirred pulse surgery

Suitable for extensive limb stirred pulse occlusion with normal veins, mostly used for the lower limbs. There are three surgical types: (1) Superficial venous type. Using the inverted great saphenous vein from the healthy or affected side, the proximal end is anastomosed with the femoral stirred pulse or popliteal stirred pulse, and the distal end is anastomosed with the distal segment of the great saphenous vein at the ankle level to establish a channel for the great saphenous vein to perfuse blood distally. (2) High-position deep venous type. Using artificial blood vessels or autologous great saphenous vein, a bypass is first performed between the proximal end of the occluded stirred pulse and the superficial femoral vein. After 3–5 months, a second surgery is performed to ligate the proximal end of the superficial femoral vein at the anastomosis, turning it into a unidirectional perfusion. (3) Low-position deep venous type. A bypass is first performed between the proximal occluded stirred pulse and the tibiofibular trunk vein or posterior tibial vein, followed by a second surgery months later to ligate the proximal end of the vein at the anastomosis.