Sacral Pressure Ulcer in Leriche Syndrome: A Case Report

Area of Science:

• Vascular Surgery
• Wound Healing
• Plastic Surgery

Background:

• Leriche syndrome, characterized by aortoiliac artery occlusion, can complicate chronic wound management.
• Sacral pressure ulcers represent a significant challenge in patient care, often associated with comorbidities.
• The interplay between vascular insufficiency and pressure ulcer healing requires careful consideration.

Observation:

• A rare case of a sacral pressure ulcer co-occurring with Leriche syndrome presented with significantly delayed wound healing.
• The occlusion involved the abdominal aorta below the renal arteries down to the common iliac arteries.
• Standard wound care protocols were insufficient due to compromised arterial blood supply.

Findings:

• Endovascular treatment successfully revascularized the iliac arteries, restoring adequate blood flow to the affected area.
• Following endovascular intervention, accelerated wound healing was observed.
• Subsequent reconstructive surgery utilizing a local flap achieved complete wound closure and successful healing.

Implications:

• This case highlights the critical importance of evaluating iliac artery blood flow in non-healing sacral pressure ulcers.
• Endovascular treatment should be considered for managing pressure ulcers complicated by aortoiliac occlusive disease.
• Post-intervention surveillance for restenosis and flap viability is crucial for successful reconstructive outcomes.