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The importance of high lumbar aortography in the Leriche syndrome
The Journal of Cardiovascular Surgery
|July 1, 1981
Insights
Conventional lumbar aortograms may miss Leriche syndrome lesions. A high puncture technique is crucial for visualizing the entire abdominal aorta in suspected cases of aortic obstruction.
Area of Science:
- Vascular Surgery
- Diagnostic Imaging
Background:
- Leriche syndrome involves aortic obstruction, typically at the lower abdominal aorta.
- Conventional lumbar aortography is a standard diagnostic tool.
Observation:
- Three patients with Leriche syndrome presented with diagnostic challenges.
- Standard low puncture lumbar aortograms failed to identify the obstructing lesions in these cases.
Findings:
- Aortic obstruction in Leriche syndrome can occur higher in the lumbar aorta, not just at the distal end.
- A high puncture (D12/L1 interspace) lumbar aortogram is necessary to visualize the entire abdominal aorta.
Implications:
- This highlights the need for adjusted imaging protocols in suspected Leriche syndrome.
- Accurate visualization of the abdominal aorta is critical for effective diagnosis and treatment planning.
Abstract:
Three patients with Leriche syndrome in whom a conventional low puncture lumbar aortogram failed to demonstrate the causative lesions are described. The aortic obstruction in Leriche syndrome is not always at the lower end of the aorta and may be high in the lumbar aorta. The importance of a high (D12/L1) puncture in patients with suspected Leriche syndrome, so that the whole of the abdominal aorta is visualised, is emphasised.