Aortic dissection manifested as leg ischemia

The ischemic leg as the only clinical manifestation of an aortic dissection is rare. Without the usual symptoms of an aortic dissection, this diagnosis may easily by overlooked during routine peripheral angiography for the ischemic limb. Three cases are reviewed in which the patient was thought to have a spontaneous peripheral vascular occlusion, but was later found to have an aortic dissection without the usual thoracic or abdominal symptoms. The radiologist should observe carefully for signs of dissection such as fusiform narrowing of a vessel, nonfilling of branches of the aorta, or displacement of the intima into aortic lumen.