62 year old female with a history of tobacco, opioid, and meth abuse as well as heart attack requiring coronary bypass and stents. She presents with bilateral lower extremity claudication (painful fatigue with physical activity) starting from her glutes.

CT angiogram shows occlusion of the lower aorta (red markings) as well as both common iliac arteries.

Vascular ultrasound shows very poor arterial waveforms throughout the lower extremities, essentially flat/absent below the knee.

She underwent a transabdominal aortobifemoral bypass to treat this.

Radiopedia article on Leriche syndrome.

Meth is bad.