Intermittent claudication due to ischaemia of the lumbosacral plexus

Wohlgemuth, Walter A.; Rottach, Klaus G.; Stoehr, M

doi:10.1136/jnnp.67.6.793

Cited by 18 publications

(5 citation statements)

References 9 publications

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“…Additionally, activity of the legs may lead to a redistribution of the blood supply in favour of the leg musculature resulting in pelvic blood flow reduction. In this situation, a proximal stenosis of the arteries supplying the lumbosacral plexus nerves can lead to a temporary mismatch between oxygen demand and supply [11,14].…”

Section: Discussion S Pathophysiological Aspectsmentioning

confidence: 99%

“…Initial clinical success was defined as regain of a walking distance of at least 200m without the onset of neurological deficits. Parts of the data regarding the neurological deficits have been published elsewhere [14]. A first follow-up examination (with/without exertion) was performed 6 month after intervention.Indication for a further reevaluation and repeat angiography was the recurrence of neurological symptoms.…”

Section: S Interventional Proceduresmentioning

confidence: 99%

“…s Key words plexus, lumbosacral · intermittent claudication · Ischaemia · angioplasty · percutaneous transluminal · follow-up olumbar artery, superior and inferior gluteal artery, lateral sacral artery [4]) or the common iliac artery itself [14]. The clinical history of the patients is normally long and the quality of life is severely impaired, but the underlying vascular pathology is potentially treatable.…”

Section: Introductionmentioning

confidence: 99%

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Percutaneous arterial interventional treatment of exercise-induced neurogenic intermittent claudication due to ischaemia of the lumbosacral plexus

Wohlgemuth

Stoehr

2002

Journal of Neurology

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Radiological interventional therapy is described in seven patients with a distinct clinical syndrome of exercise-induced neurogenic intermittent claudication due to a reversible ischaemia of the lumbosacral plexus during walking accompanied by transient neurologic deficits. This condition was presumably caused by a reversible vascular steal phenomenon during exertion. The underlying vascular conditions were stenoses of the internal and/or common iliac arteries. All patients underwent percutaneous transluminal angioplasty (PTA) during the period from 1988 to 2001; an additional stent was placed in two patients. After a mean follow-up period of 18 months, four patients were asymptomatic, two had an improvement in walking-distance of 300 m and 800 m, respectively, and one patient developed a peripheral intermittent claudication without neurological complaints. In four patients, however, a further intervention was required. In patients with intermittent claudication due to exercise induced ischaemia of the lumbosacral plexus, a successful treatment is possible by means of PTA. Repeat intervention is justified if symptoms recur.

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Section: Discussion S Pathophysiological Aspectsmentioning

confidence: 99%

Section: S Interventional Proceduresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Percutaneous arterial interventional treatment of exercise-induced neurogenic intermittent claudication due to ischaemia of the lumbosacral plexus

Wohlgemuth

Stoehr

2002

Journal of Neurology

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“…Small case series have identified a peculiar clinical syndrome associated with chronic lumbosacral plexus ischaemia, comprising intermittent claudication, exercise-induced pain, paraesthesia and motor deficits. The most frequent causes are severe stenosis or occlusion of the supplying arteries from the lumbosacral plexus 4…”

Section: Discussionmentioning

confidence: 99%

Ischaemic lumbosacral plexopathy following aortic dissection

et al. 2022

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A 57-year-old man was diagnosed with acute myocardial infarction and Stanford type A aortic dissection that had spread to the common iliac arteries. He underwent a Bentall procedure for vascular repair. Immediately after surgery, he developed numbness and severe weakness in his left leg. On examination, he had hypotonia, absent deep tendon reflexes, weakness in the left leg (Medical Research Council (MRC) scale for muscle strength - 0/5 distal, 3/5 proximal) and reduced sensation in the left leg. Electromyography confirmed subacute involvement of the left lumbar and lumbosacral plexus. MR scan of the lumbar plexus showed diffuse muscle oedema involving the left gluteus maximus. We diagnosed ischaemic lumbosacral plexopathy secondary to extensive aorta dissection and internal iliac artery occlusion. We discuss the clinical features of ischaemic plexopathy and the diagnostic approach and review the vascular anatomy of the lumbosacral plexus.

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“…Since the lumbosacral plexus derives blood supply from branches of the internal iliac artery, an ischemic lesion of the lumbosacral plexus can be attributed to stenosis or occlusion of the iliac arteries or distal abdominal aorta. 5 Disruption of proximal vascular supply in the lower extremities may also result in an acute distal axonal-loss mononeuropathy (ischemic monomelic neuropathy). In contrast to lumbosacral plexopathy secondary to aortic occlusion, this syndrome lacks the hallmark signs of vascular insufficiency, such as pallor, coldness, and pulselessness.…”

mentioning

confidence: 99%