Mapping the Blockage: CTA’s Role in Leriche Syndrome Diagnosis

Leriche syndrome, also known as aortoiliac occlusive disease, is a chronic form of peripheral arterial disease resulting from progressive atherosclerotic obstruction of the terminal abdominal aorta and/or iliac arteries. It is most commonly seen in older males with cardiovascular risk factors such as hypertension, diabetes, dyslipidemia, and smoking. The classic clinical presentation includes bilateral lower limb claudication, absent femoral pulses, and erectile dysfunction. However, many patients remain asymptomatic or present with atypical symptoms due to the gradual development of collateral circulation. We report the case of a 72-year-old male with a known history of chronic heart failure, who presented with progressive lower limb discomfort and fatigue. Diagnosis of Leriche syndrome was made through computed tomography angiography (CTA), which revealed a type II Leriche syndrome with complete occlusion of the abdominal aorta and bilateral iliac arteries. Extensive collateral circulation was observed, indicating chronic disease progression. Given the patient's cardiac comorbidities, a conservative approach was initially chosen, consisting of statin therapy, antiplatelet agents, and optimization of heart failure management. This case emphasizes the importance of CTA in diagnosing Leriche syndrome, determining the extent of vascular occlusion and collateral circulation, and guiding treatment decisions to improve patient prognosis.