Clinical Misdiagnosis Analysis of Lower Extremity Arteriosclerosis Obliter-ans

YANG Zhanhui; WANG Peng

doi:10.3969/j.issn.1002-3429.2025.03.005

Abstract：Objective To analyze the causes of clinical misdiagnosis of lower extremity arteriosclerosis obliterans(LASO)in order to improve the diagnosis and treatment level of clinicians.Methods The clinical data of 2 patients with LASO who had been misdiagnosed from January 2022 to January 2024 were retrospectively analyzed.Results One patient was diagnosed with thromboangiitis obliterans in the local hospital for many times due to numbness of the right leg,intermittent claudication,persistent pain in the right toe and the calf,and loss of sensation at the end of the right toe.The symptoms were not relieved but worsened after corresponding treatment,and the disease was then confirmed as right femoral arteriosclerotic obliterans by color Doppler ultrasound.The duration of misdiagnosis was 3 years.After diagnosis and appropriate treatment,the progression of gangrene stopped.Artificial blood vessel transplantation and amputation of the right anterior foot were per-formed.After 3-month follow-up,the symptoms disappeared and the pulsation of posterior tibial artery and dorsal foot artery recovered.A patient with intermittent claudication in the right lower limb accompanied by pain and discomfort in the lower back underwent lumbar CT examination,and lumbar intervertebral disc herniation was considered.After appropriate treat-ment,the symptoms of intermittent claudication worsened progressively with ulceration and necrosis of the skin beneath the right knee,and arteriography in the right lower limb was performed.Occlusion of the right common iliac artery and external il-iac artery was found during the operation,which was diagnosed as LASO.The misdiagnosis lasted 1 year.After diagnosis,en-dovascular stenting was performed,and the pulsation of right femoral artery and right dorsal foot artery was restored.There were no symptoms of lower limb discomfort at 1 month after surgery.Conclusion The early manifestations of LASO are var-ied,and the misdiagnosis rate is high.Physicians should improve their understanding of the disease,carefully inquire about the history and physical examination,pay attention to the comprehensive analysis of clinical data,and perform specific exami-nation methods in early stage to reduce the misdiagnosis rate.