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The ischemic leg: a clue to dissecting aneurysm
Cardiovascular Clinics
|January 1, 1975
Summary
Acute ischemic leg symptoms can indicate dissecting aneurysms. This crucial sign may be overlooked, but considering aortic dissection in patients with leg ischemia and related pain can improve diagnosis and outcomes.
Area of Science:
- Vascular Surgery
- Cardiology
- Diagnostic Imaging
Background:
- Dissecting aneurysms can present with varied symptoms, sometimes masking the underlying condition.
- Acute limb ischemia is a recognized but often under-recognized manifestation of aortic dissection.
Purpose of the Study:
- To highlight the significance of acute ischemic leg as a presenting symptom of dissecting aneurysms.
- To emphasize the importance of considering aortic dissection in patients with unexplained acute limb ischemia.
Main Methods:
- Retrospective review of 65 patients diagnosed with dissecting aneurysms.
- Analysis of presenting symptoms, focusing on the incidence and impact of acute ischemic leg.
Main Results:
- Seventeen out of 65 patients (26%) with dissecting aneurysms presented with acute ischemic leg.
- The ischemic leg was often the primary symptom, leading to diagnostic delays.
- Medical management of seven patients with limb ischemia resulted in survival with intact limbs in five, with pulse return within one month.
Conclusions:
- Acute ischemic leg is a critical diagnostic clue for dissecting aneurysms.
- Aortic dissection should be suspected in patients with acute limb ischemia, particularly with associated chest, neck, or back pain.
- Limb salvage is achievable with medical management in select cases of aortic dissection presenting with ischemia.