학술논문

Treatment Strategy for Leriche Syndrome Complicated with Ischemic Heart Disease / 虚血性心疾患を合併した Leriche 症候群に対する治療戦略
Document Type
Journal Article
Source
日本心臓血管外科学会雑誌 / Japanese Journal of Cardiovascular Surgery. 2021, 50(4):283
Subject
Leriche syndrome
Leriche症候群
aortoiliac occlusive disease
coronary artery bypass grafting
endovascular treatment
ischemic heart disease
冠動脈バイパス術
虚血性心疾患
血管内治療
閉塞性動脈疾患
Language
Japanese
ISSN
0285-1474
1883-4108
Abstract
Leriche syndrome is often complicated with ischemic heart disease (IHD). In such cases, as the internal mammary artery (IMA) supplies blood to the lower-limbs through a collateral network, coronary artery bypass grafting (CABG) using IMA is considered to worsen the lower-limb ischemia and use of intra-aortic balloon pumping prior to lower limb revascularization is not possible. Recent advances in endovascular technology enable us to perform endovascular treatment (EVT) even in Leriche syndrome. In 3 patients diagnosed with Leriche syndrome associated with IHD, tailor-made treatments were performed as one-stage or two-stage surgeries. Various techniques such as percutaneous coronary intervention (PCI), CABG, and open surgical revascularization or EVT of lower limbs were employed. EVT is a less invasive and more attractive alternative to open surgical revascularization, it led to new treatment options in patients with this particular circumstance. Considering the severity of pathophysiology, treatment strategy should be determined on a case-by-case basis.