The ischemic leg: a clue to dissecting aneurysm.

The acute ischemic leg may be an important clue to the diagnosis of a dissecting aneurysm. Seventeen of 65 patients with dissecting aneurysms presented with this picture. The ischemic leg was often the dominant feature and obscured the correct diagnosis. The possibility of aortic dissection should be considered in any patient with an acutely ischemic leg, especially if there is any accompanying chest, neck, or back discomfort. The presence of an ischemic limb is not necessarily an indication for surgical repair of the dissection itself. Of seven patients treated medically, five survived with limbs intact, and in all five the pulses returned within one month.