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Aortic dissection manifested as leg ischemia.

T J White, M L Pinstein, R L Scott

AJR. American Journal of Roentgenology

|August 1, 1980

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Aortic dissection can present solely as an ischemic leg, mimicking peripheral vascular occlusion. Radiologists must carefully examine peripheral angiograms for subtle signs of dissection to avoid misdiagnosis.

Area of Science:

Vascular Surgery
Diagnostic Imaging
Cardiology

Background:

Aortic dissection is a serious condition often presenting with chest or abdominal pain.
Ischemic leg is an uncommon initial symptom of aortic dissection.
Peripheral angiography is frequently performed for limb ischemia, potentially overlooking aortic pathology.

Observation:

Three cases are presented where aortic dissection was initially misdiagnosed as spontaneous peripheral vascular occlusion.
Patients lacked typical thoracic or abdominal symptoms of aortic dissection.
The only presenting symptom was an ischemic leg.

Findings:

Aortic dissection can manifest exclusively as peripheral ischemia.
Subtle angiographic signs of aortic dissection may be present even without classic symptoms.

Related Experiment Videos

Key signs include fusiform narrowing, nonfilling of aortic branches, and intimal displacement.

Implications:

Increased awareness of this rare presentation is crucial for timely diagnosis.
Radiologists should meticulously review peripheral angiograms for signs suggestive of aortic dissection.
Early detection can prevent catastrophic complications associated with undiagnosed aortic dissection.