Aortic bifurcation syndrome I74.0

Acute or tardive occlusion of the abdominal aorta in the area where it branches into the two iliac arteries (aortic bifurcation syndrome or Leriche syndrome).

Chronic Leriche syndrome: In most cases, the occlusion of the aorta develops slowly over years due to arteriosclerosis, so that collateral circulation can develop and the symptoms are delayed. Symptoms depend on the stage of the arterial occlusive disease: pain on exertion such as intermittent claudication, trophic complaints; ischialgiform complaints or impotentia coeundi may also occur.

Affects mainly men between 50 and 60 years of age (usually severe nicotine abuse).

Acute Leriche syndrome: sudden embolic occlusion of the abdominal aorta due to thrombosis or embolism from arteriosclerotic plaques. Patients with cardiac arrhythmia (absolute arrhythmia, pacemaker) or an artificial heart valve are particularly affected.

Treatment is by surgery, in chronic Leriche syndrome by fitting a Y-prosthesis, in acute Leriche syndrome by emergency embolectomy of both groin arteries.

1. Verma H et al (2013) Surgical and endovascular treatment of occlusive aortic syndromes. J Cardiovasc Surg (Torino) 54(1 Suppl 1):55-69.
2. Wooten C et al (2014) Anatomical significance in aortoiliac occlusive disease. Clin Anat 27:1264-1274.