{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T21:28:57Z","timestamp":1772832537085,"version":"3.50.1"},"reference-count":17,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2009,2,3]],"date-time":"2009-02-03T00:00:00Z","timestamp":1233619200000},"content-version":"vor","delay-in-days":3566,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[1999,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:italic>Background and hypothesis:<\/jats:italic> Lower extremity symptoms accompanying dissecting hematomas of the aorta are well described. Isolated lower extremity ischemia as the presenting syndrome of aortic dissection is rare and frequently misinterpreted so that the diagnosis of aortic dissection is delayed or missed, often with catastrophic results. This study was undertaken to determine its common characteristics and to reinforce recognition of this life\u2010threatening phenomenon.<\/jats:p><jats:p><jats:italic>Methods:<\/jats:italic> After the first patient in our series presented with isolated lower extremity ischemia due to aortic dissection, a prospective search for similar presentations was undertaken over 2 years. We also conducted a retrospective search for all aortic dissections at our hospital for the past 10 years and a MEDLINE search for all reported aortic dissections in the literature of the past 20 years, as well as for all reports of isolated ischemia of the lower extremities due to aortic dissection.<\/jats:p><jats:p><jats:italic>Results:<\/jats:italic> Three patients with isolated ischemia of the lower extremities due to aortic dissection were found prospectively after the index case. Over 10 years, 40 patients with acute aortic dissection were diagnosed at our hospital. The MEDLINE search revealed 1,751 aortic dissections of which 10% had lower extremity symptoms. Only 10 cases of aortic dissection were reported as lower extremity ischemia with symptoms isolated to one or both lower extremities. Smoking, hypertension, male gender, hypercholesterolemia, and recent history of coronary artery bypass grafting were common predisposing risk factors for this rare presentation.<\/jats:p><jats:p><jats:italic>Conclusion:<\/jats:italic> Symptomatic isolated ischemia of the lower extremities due to aortic dissection is rare and often missed. Awareness of its characteristics, aided by the acronym ILEAD, made it possible to suspect the true origin of this misleading syndrome.<\/jats:p>","DOI":"10.1002\/clc.4960220511","type":"journal-article","created":{"date-parts":[[2009,2,4]],"date-time":"2009-02-04T03:09:47Z","timestamp":1233716987000},"page":"353-356","source":"Crossref","is-referenced-by-count":23,"title":["ILEAD\u2010ischemia of the lower extremities due to aortic dissection: The isolated presentation"],"prefix":"10.1002","volume":"22","author":[{"given":"David","family":"Spodick","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2009,2,3]]},"reference":[{"key":"e_1_2_1_2_2","first-page":"201","article-title":"The ischemic leg: A clue to dissecting aneurysm","volume":"7","author":"Young JR","year":"1975","journal-title":"Cardiovasc Clin"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM196205172662006"},{"key":"e_1_2_1_4_2","first-page":"649","article-title":"Dissecting hematoma presents as acute lower limb ischemia: Diagnostic patient profile and management","volume":"24","author":"Shah PM","year":"1983","journal-title":"J Cardiovasc Surg"},{"key":"e_1_2_1_5_2","first-page":"118","article-title":"Dissection and dissecting aneurysms of the aorta: Twenty year follow\u2010up of five hundred and twenty\u2010seven patients treated surgically","volume":"92","author":"DeBakey ME","year":"1982","journal-title":"Surgery"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-195809000-00003"},{"issue":"42","key":"e_1_2_1_7_2","first-page":"955","article-title":"Dissecting aneurysm as a cause of acute non\u2010traumatic ischemia of the lower limbs","volume":"47","author":"Dutkiewicz A","year":"1992","journal-title":"Polski Tygodnik Lekarski"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(82)90513-X"},{"issue":"8","key":"e_1_2_1_9_2","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1056\/NEJM199102213240808","article-title":"Case records of the Massachusetts General Hospital. 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