Leriche syndrome presents with the classic triad of: buttock and thigh claudication, absent femoral pulses, and impotence in males. This results from occlusion at which anatomical level?
- A Bilateral superficial femoral artery occlusion
- B Aortoiliac occlusive disease at or above the aortic bifurcation ✓
- C Bilateral common iliac artery stenosis only
- D Infrarenal aortic thrombosis below the renal arteries
Explanation
Leriche syndrome is caused by atherosclerotic occlusion of the distal aorta and aortic bifurcation, affecting the origins of both common iliac arteries. The classic triad — bilateral buttock/thigh claudication (absent iliac and femoral pulses), impotence (due to lack of flow in the internal pudendal arteries via internal iliac arteries), and muscle wasting — was described by René Leriche in 1940. Management involves aorto-bifemoral bypass grafting (gold standard for extensive aortoiliac disease) or endovascular kissing stent placement for localized iliac stenoses (TASC II classification guides decision-making).
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.