An Elderly Patient with Leriche Syndrome Complicated by Congestive Heart Failure and Rhabdomyolysis

A 64-year-old man, who had had bilateral intermittent claudication and leg pain for five years, was admitted because of sudden onset of severe leg pain, and acute respiratory failure. Laboratory data showed markedly elevated serum CK of 73, 050IU/L, and urinary myoglobin of 430, 000ng/ml. A diagnosis of rhabdomyolysis was made. Renal dialysis was required for the next two days because of acute renal failure. The aortogram was performed on the 32nd day and disclosed complete obstruction of the abdominal aorta immediately distal to the bilateral renal arteries. Good collateral flow was noted to the popliteal arteries. On the 49th day, the patient successfully underwent extra-anatomical bypass surgery (axillo-bifemoral bypass). The mechanism of rhabdomyolysis in this elderly patient was discussed.