Treatment of Leriche Syndrome with Absent Femoral Pulse in Acute Limb Ischemia from In Situ Native-Vessel Thrombosis
This protocol addresses Leriche syndrome presenting as acute limb ischemia caused by in situ thrombosis of the native vessel — a distinct, time-sensitive scenario with a specific management pathway.
Acute-onset lower-extremity pain with an absent femoral pulse on palpation, occurring against a long history of claudication and without recent surgical intervention. Acute limb ischemia in this context can arise from in situ thrombosis of the native artery, among other mechanisms including thromboembolism and atheroembolism.
The protocol for this scenario centres on surgical revascularization; the precise indications, patient-selection criteria, and decision algorithm are detailed in the full regimen.
References
DOI: 10.1016/j.jacr.2025.02.024
Long history of claudication. Acute-onset left lower-extremity pain. Absent left femoral pulse by palpation, faint audible DP and PT Doppler signals.
ALI occurs because of thromboembolism, atheroembolism, in situ thrombosis of the native artery, or thrombosis of a surgical bypass graft.
Surgical approaches should be reserved for patients in whom thrombolysis or endovascular thrombectomy failed, for situations in which an unacceptable delay due to attempted endovascular techniques jeopardizes the viability of a limb, or for nonviable limbs.
View source ↗