Aortic Dissection Presenting as Isolated Lower Leg Ischemia

Background: Aortic dissections that present only with symptoms of lower extremity ischemia are rare. Few case reports exist documenting this phenomenon. Objectives: We report an unusual case of aortic dissection presenting as unilateral lower extremity pain. Case Report: A 56-year-old man presented with left lower extremity pain of 1 h duration. He had no associated complaints. Doppler imaging revealed decreased flow in the left iliac artery, thus, initial treatment with anticoagulation was begun for presumptive obstruction. Subsequent imaging with arteriography revealed a Stanford type A/DeBakey type 1 aortic dissection. This was confirmed by computer-assisted tomography angiography, and the patient was taken to surgery for repair. Conclusion: It is important to consider the connection between lower extremity symptoms and possible aortic dissection.