Leriche sendromlu hastada sol internal mammarian arter darlığına anjiyoplasti uygulanması

Leriche sendromu nadir rastlanan bir periferik vasküler hastalık tipi olmasına karşın ciddi bir morbidite nedenidir. Bir yada iki bacakta kladikasyo, erkeklerde erektil disfonksiyon ve femoral nabızlarda azalma veya kaybolma Leriche sendromunun karakteristik semptomlarıdır. Bununla birlikte, semptomlar gelişen kollateral dolaşıma göre değişkenlik gösterebilir. Leriche sendromlu hastalarda sol internal mammarian arter (LİMA), kollateral dallar aracılığıya alt ekstremite için alternatif kan perfüzyonu sağlayan damarlardan biridir. Periferik arter hastalığı olup koroner by-pass için LİMA grefti kullanılan hastalarda post-op dönemde alt ekstremitede iskemi saptanan olgular bildirilmiştir. Olgumuz 4 ay öncesinde öpere olan Leriche sendromu hastası olup akut greft trombozu tanısıyla yatırıldı. İskemi altındaki sol alt ekstremiteye perfüzyon sağlamak amacıyla anjiyografi sonrasında saptanan LİMA stenozuna anjiyoplasti-stent işlemi uygulandı.

Angioplasty of left internal mammary ertery stenosis in a patient diagnosed as leriche syndrome: A case report

Leriche syndrome is a rare type of peripheric vascular disease which can cause severe morbidity. Claudication in one or both legs, erectil dysfunction in man and diminution or absence of femoral pulses are characteristic symptoms of Leriche syndrome. However, symptoms can vary according to formation of collateral circulation. Left internal mammary artery (LIMA) can be an alternative blood supply pathway to lower extremity via collateral anastomosis over abdominal wall. There was a reported case with occurance of lower limb ischemia after coronary bypass surgery with a LIMA usage. Here we present an of acute graft trombosis in a patient with Leriche syndrome who was operated 4 months ago. We performed angioplasty and stent to LIMA stenosis in order to obtain sufficient blood supply to ischemic lower extremity.

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