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October 1965

Intermittent Claudication Secondary to Congenital Absence of Iliac Arteries

Arch Surg. 1965;91(4):604-606. doi:10.1001/archsurg.1965.01320160058013

OBSTRUCTION of the terminal aorta and iliac arteries produces a characteristic series of symptoms that were described by Leriche in 1940.1 Typically, the patient complains of fatigue and pain in hips, thighs or calves appearing after exercise; he has pallor of the legs on elevation, absent or weak arterial pulsations in the lower extremities, and inability to maintain a penile erection. Intermittent claudication is usually more severe on one side but is present bilaterally. Leriche also commented on the slow progress of the syndrome and the rare occurrence of ischemic skin lesions of the lower extremities.

Atherosclerotic involvement of the aortic bifurcation and iliac arteries constitutes the etiological agent of this syndrome in the vast majority of cases.2,3 Idiopathic fibrous retroperitonitis has been reported to cause partial obstruction of the terminal aorta and iliac arteries with intermittent claudication of the calves, thighs, and hips.4,5,6

The present report

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