Aortic bifurcation syndrome I74.0

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

Chronic Leriche Syndrome: in most cases, the closure of the aorta is caused slowly over years by arteriosclerosis, so that by-passes (collaterals) can develop and the symptoms appear with delay. Symptoms depending on the stage of the occlusive arterial disease: pain on exertion such as intermittent claudication, trophic complaints; ischialgiform complaints or impotentia coeundi may also occur.

Mainly men between 50 and 60 years of age are affected (usually strong nicotine abuse).

Acute Leriche syndrome: sudden embolic occlusion of the abdominal aorta due to thrombosis or embolism from arteriosclerotic plaques. Patients with cardiac dysrhythmia (absolute arrhythmia, pacemaker) or 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.