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Leriche Syndrome Visualized by 3-Dimensional Multislice Computed Tomography Angiography

2004; Lippincott Williams & Wilkins; Volume: 110; Issue: 8 Linguagem: Inglês

10.1161/01.cir.0000139864.14256.1d

1524-4539

Riccardo Iannaccone, Carlo Catalano, Massimiliano Danti, Filippo Mangiapane, Roberto Passariello,

Advanced MRI Techniques and Applications

HomeCirculationVol. 110, No. 8Leriche Syndrome Visualized by 3-Dimensional Multislice Computed Tomography Angiography Free AccessReview ArticlePDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissionsDownload Articles + Supplements ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toSupplemental MaterialFree AccessReview ArticlePDF/EPUBLeriche Syndrome Visualized by 3-Dimensional Multislice Computed Tomography Angiography Riccardo Iannaccone, Carlo Catalano, Massimiliano Danti, Filippo Mangiapane and Roberto Passariello Riccardo IannacconeRiccardo Iannaccone From the Department of Radiological Sciences, University of Rome–La Sapienza, Policlinico Umberto I, Rome, Italy. , Carlo CatalanoCarlo Catalano From the Department of Radiological Sciences, University of Rome–La Sapienza, Policlinico Umberto I, Rome, Italy. , Massimiliano DantiMassimiliano Danti From the Department of Radiological Sciences, University of Rome–La Sapienza, Policlinico Umberto I, Rome, Italy. , Filippo MangiapaneFilippo Mangiapane From the Department of Radiological Sciences, University of Rome–La Sapienza, Policlinico Umberto I, Rome, Italy. and Roberto PassarielloRoberto Passariello From the Department of Radiological Sciences, University of Rome–La Sapienza, Policlinico Umberto I, Rome, Italy. Originally published24 Aug 2004https://doi.org/10.1161/01.CIR.0000139864.14256.1DCirculation. 2004;110:e77–e78A 39-year-old man presented to our hospital with severe thigh, hip, and buttock claudication and diminished femoral pulses. Color Doppler ultrasonography revealed absence of flow in both common iliac arteries, suggesting the diagnosis of Leriche syndrome. Preoperative computed tomography (CT) angiography was subsequently performed using a multislice spiral CT scanner (Somatom Plus 4 Volume Zoom, Siemens) to confirm the diagnosis and provide a vascular "road map" for the surgical procedure.After intravenous injection of 130 mL of nonionic iodinated contrast material (Iomeron 400, Bracco), CT scanning of the abdominal aorta was performed using a high-resolution protocol (slice thickness, 3.0 mm; reconstruction interval, 1.0 mm). After acquisition, CT images were transferred to a workstation and 3-dimensional (3D) volume rendering images, as well as multiplanar reconstructions, were generated using a dedicated software package (Vitrea 2, Vital Images).The 3D volume rendering reconstructions (Figure 1A and Movie I) provided a selective visualization of the arterial circulation, showing complete obstruction of the sub-renal aorta and common iliac arteries, with superficial collateral circles and recanalization of common femoral arteries. The multiplanar reconstruction along the sagittal plane (Figure 1B) clearly depicted the location and extent of a thrombus within the abdominal aorta. Download figureDownload PowerPointFigure 1. A, Preoperative multislice spiral CT angiography with 3D volume rendering reconstruction. After careful manual segmentation, the arterial vessels are displayed selectively with the osseous structures seen in transparency. CT images demonstrate complete obstruction of the sub-renal aorta and common iliac arteries with excellent detail. There is reconstitution of the common femoral arteries bilaterally via circumflex iliac (arrows) and inferior epigastric arteries (arrowheads). B, The multiplanar reconstruction along the sagittal plane clearly shows the location and extent of a thrombus (arrow) within the abdominal aorta.The patient subsequently underwent bypass surgery and CT angiography was performed for follow-up evaluation. The 3D volume rendering reconstructions (Figure 2 and Movie II) demonstrated complete resolution of the aortic obstruction. Download figureDownload PowerPointFigure 2. Postoperative multislice spiral CT angiography with 3D volume rendering reconstruction. The 3D image shows complete resolution of the aortic obstruction.Movies I and II are available in the online-only Data Supplement at http://www.circulationaha.org.FootnotesCorrespondence to Riccardo Iannaccone, Via Arturo Graf, 40, 00137 Rome, Italy. E-mail [email protected] eLetters(0) eLetters should relate to an article recently published in the journal and are not a forum for providing unpublished data. Comments are reviewed for appropriate use of tone and language. Comments are not peer-reviewed. Acceptable comments are posted to the journal website only. Comments are not published in an issue and are not indexed in PubMed. Comments should be no longer than 500 words and will only be posted online. References are limited to 10. Authors of the article cited in the comment will be invited to reply, as appropriate. Comments and feedback on AHA/ASA Scientific Statements and Guidelines should be directed to the AHA/ASA Manuscript Oversight Committee via its Correspondence page. Sign In to Submit a Response to This Article Previous Back to top Next FiguresReferencesRelatedDetailsCited By Roxas R, Gallegos L and Bailitz J (2011) Rapid Detection of Aortic Occlusion With Emergency Ultrasonography, Annals of Emergency Medicine, 10.1016/j.annemergmed.2010.09.001, 58:1, (21-23), Online publication date: 1-Jul-2011. Morrow D, Guha S, Sweeney C, Birney Y, Walshe T, O'Brien C, Walls D, Redmond E and Cahill P (2008) Notch and Vascular Smooth Muscle Cell Phenotype, Circulation Research, 103:12, (1370-1382), Online publication date: 5-Dec-2008. Romano L, Ruggiero G and Russo G Ischemia da ipoafflusso del rene destro da occlusione trombotica dell'aorta sottorenale e dei vasi iliaci (sindrome di Leriche) Imaging nelle urgenze vascolari — Body, 10.1007/978-88-470-1072-7_42, (83-84) Ando H, Funabashi N, Uehara M, Suzuki M, Sato H, Hashimoto M, Ishida A, Yanagawa N, Fukuchi Y, Kikawa T, Imada M and Komuro I (2007) Abnormal collateral arterial systems in Takayasu's arteritis and Leriche's syndrome evaluated by whole body acquisition using multislice computed tomography, International Journal of Cardiology, 10.1016/j.ijcard.2006.08.121, 121:3, (306-308), Online publication date: 1-Oct-2007. August 24, 2004Vol 110, Issue 8 Advertisement Article Information Metrics https://doi.org/10.1161/01.CIR.0000139864.14256.1DPMID: 15326081 Originally publishedAugust 24, 2004 PDF download Advertisement Subjects Computerized Tomography (CT) Imaging