Синдром Леріша як тривалий часовий континуум судинного ураження: від початкових клінічних проявів до можливого фатального завершення (актуальність міждисциплінарної співпраці за власними клінічними спостереженнями)

Abstract

Leriche syndrome typical signs include incapability for erection maintaining, fatigue feeling originating from both lower limbs, bilateral claudication with ischemic pain and lack or reduction of peripheral pulse (starting from femoral segment) combined with paleness or coldness of both lower limbs. The disease commonly affects men, and risk factors include hypertension, diabetes mellitus, hyperlipidemia and smoking. Currently the disorder is referred to type D aortoiliac injuries according to Trans-Atlantic Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). Data on psychiatric morbidity in Leriche syndrome is scarce. Some publications are dedicated in such a state to depressive disorder and erectile dysfunction, which were observed in psychiatric outpatient department. These may have several reasons, such as obesity, hypertension, diabetes mellitus, hypercholesterolemia and lower urinary tract symptoms. Moreover, erectile dysfunction is believed to be a strong predictor of general and coronary atherosclerosis. Leriche syndrome and penis arteries obstructive disease are considered to be two main reasons of impotence. Other reasons of Leriche syndrome may be lifestyle factors which are common with atherosclerosis: insufficient physical exercises, imbalanced diet and smoking. Statistics on psychiatric morbidity in Leriche syndrome is hard to receive because of multiple risk factors, partially because of atherosclerosis, which is the risk for vascular depression. The article represents historical data about prominent doctors in the history of vascular surgery who touched upon the problems of Leriche syndrome. The authors describe their own clinical observations of acute patient with prolonged development of full clinical manifestation with fatal outcome.