Acute Leriche's syndrome in a patient undergoing coronary artery bypass grafting with extracorporeal circulation

We are reporting a case of an acute thromboembolic obstruction of the aorti c bifurcation in a 66-year-old patient undergoing coronary artery bypass gr afting with extracorporeal circulation. After declamping of the aorta,the a rterial pressure measured in the femoral artery suddenly dropped, whereas t he pressure measured in the aortic cannula and in both radial arteries stay ed normal. Transoesophageal echocardiography was performed to exclude an ac ute aortic dissection. While the patient always had a constant sinus rhythm ,an angiography following the end of surgery, showed a complete obstruction of the abdominal aorta. Subsequent embolectomy through bifemoral arterioto mies was performed and a histotogicaly fresh embolus (6,5 g in weight) was extracted. Neither the pre- and intraoperative echocardiography, nor the pr eoperative ventriculography showed signs of an intracardiac thrombus. Insuf ficient anticoagulation a nd a lack of inhibitor potential were almost excl uded. Considering the histological findings, we assumed that the embolus wa s formed intraoperatively. Without further complications the patient left o ur department on the 8th postoperative day.