Leriche syndrome results from occlusion of which vessels?

• A. Renal arteries
• B. Internal iliac arteries
• C. Distal aorta and proximal common iliac arteries
• D. Femoral artery bifurcation

Answer: (C)

Leriche syndrome is occlusive disease at the distal aorta where it meets the common iliac arteries. When the blockage sits at the aortic bifurcation, flow to both lower extremities is compromised early in the arterial tree, producing the classic pattern of symptoms: claudication in the buttocks and thighs, diminished or absent femoral pulses, and in men, impotence from pelvic organ ischemia. The affected territory is the distal aorta with the proximal portions of the common iliac arteries, so this specific location explains the combination of leg symptoms and pelvic/genital dysfunction. Occlusion higher up (such as renal arteries) or in other branches would present with different signs, and occlusion further down at the femoral bifurcation would cause leg symptoms without the characteristic pelvic ischemia.