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Lower-limb ischemia as the sole presentation is rare, with few cases described. This open-access case report presents an atypical presentation characterized by lower-limb pain, aiming to highlight diagnostic challenges and the importance of timely recognition in emergency settings.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/stanford-type-a-aortic-dissection-manifesting-as-acute-lower-limb-ischemia/408288/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/stanford-type-a-aortic-dissection-manifesting-as-acute-lower-limb-ischemia/408288.png","ImageObject",300,407,{"name":92,"@type":93},"Mafia Boss","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-02","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is aortic dissection considered an emergency?","Question",{"text":112,"@type":113},"Aortic dissection is life-threatening and requires prompt diagnosis and immediate management to prevent severe complications.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How did the case present atypically?",{"text":117,"@type":113},"The aortic dissection manifested solely as acute lower-limb ischemia, presenting with sudden pain in the left lower limb rather than typical chest pain.",{"name":119,"@type":110,"acceptedAnswer":120},"What treatment and outcome are reported?",{"text":121,"@type":113},"The patient underwent surgery with resection of the ascending aorta and aortic arch and interposition of a Dacron graft; pulses in the left lower limb were restored postoperatively, and the patient was discharged after follow-up without sequelae.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},408288,1790817089,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":24,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},962090760730,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","Review began 11/12/2025  \nReview ended 11/27/2025  \nPublished 12/01/2025  \n© Copyright 2025  \nPaccaud et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CCBY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98241  \nOpen Access Case Report  \nStanford Type A Aortic Dissection Manifesting as Acute Lower Limb Ischemia  \nHeloise Paccaud 1, Guérisse Fabien 2 , Michael Beauprez 2, Quentin Vangyte 2  \n1. Emergency Medicine, Erasmus Hospital, Brussels, BEL 2. Emergency Medicine, CHU de Charleroi, Lodelinsart, BEL Corresponding author: Heloise Paccaud, [heloise.paccaud@gmail.com](heloise.paccaud@gmail.com)  \nAbstract  \nAortic dissection is a life-threatening emergency that requires prompt diagnosis. Clinical presentations vary and can be typical, atypical, or even asymptomatic. Aortic dissection manifesting solely as lower-limb ischemia is uncommon, with only a limited number of such cases reported in the literature. This report aims to describe an atypical clinical presentation of aortic dissection characterized by pain in a lower limb.  \nCategories: Emergency Medicine, Cardiac/Thoracic/Vascular Surgery  \nKeywords: acute, acute lower limb ischaemia, aortic dissection, lower limb pain, stanford-a  \nIntroduction  \nType A aortic dissection is a surgical emergency that requires immediate management [1] . While it usually presents with chest pain radiating to the interscapular region, it can also manifest with atypical symptoms [2] . Among the complications resulting from aortic dissection, malperfusion is particularly severe. Malperfusion syndrome is characterized by ischemia of an organ or limb caused by compression of the true lumen due to the dissection. Acute type A aortic dissection-related lower-limb malperfusion is usually reversed after timely proximal aortic repair. This report describes a clinical case of type A aortic dissection with an atypical presentation.  \nCase Presentation  \nA 65-year-old man presented to the emergency department of Charleroi University Hospital on his own due to sudden pain that appeared in the morning in his left lower limb. His medical history included hypertension, dyslipidemia, and a left middle cerebral artery (MCA) stroke in 2010. On physical examination, his vital signs were within normal limits-heart rate: 81 beats/minute, respiratory rate: 21 breaths/minute, oxygen saturation on room air: 97%, temperature: 36.4 °C, blood pressure: 143/65 mmHg in the left upper limb and 151/67 mmHg in the right upper limb.  \nOn clinical examination, the patient was agitated, confused, and uncomfortable. Neurologically, there was left lower facial paralysis, left-sided hemiplegia, and hypoesthesia of the left lower limb. Vascular examination revealed that the left lower limb was warm and pale, with a capillary refill time greater than three seconds. No pulse was detected in the left femoral, popliteal, or dorsalis pedis arteries, while upper extremity pulses were intact. The initial blood test results showed no abnormalities and were within normal limits (Table 1) .  \nHow to cite this article  \nPaccaud H , Fabien G , Beauprez M , et al. (December 01 , 2025) Stanford Type A Aortic Dissection Manifesting as Acute Lower Limb Ischemia. Cureus 17(12): e98241. DOI 10.7759/cureus.98241  \nTest Result Reference range  \nHemoglobin White blood cells Neutrophils Lymphocytes Monocytes Platelets  \nC-reactive protein (CRP)  \nProthrombin time (PT)  \nInternational normalized ratio (INR) Activated partial thromboplastin time (APTT) Fibrinogen  \nSodium Potassium Chloride Bicarbonate Urea Creatinine eGFR (MDRD) Total bilirubin  \nAlkaline phosphatase  \nGamma-glutamyl transferase (GGT) AST (GOT)  \nALT (GPT) Lipase Troponin  \n15.4 g/dL 7090 /μL 3400 /μL 2930 /μL  \n580 /μL  \n152 000 /μL \u003C1 mg/L 100%  \n1  \n22 seconds 2.3 g/L  \n142 mmol/L 3.5 mmol/L 108 mmol/L 18 mmol/L","cbCairxi3HKpFccp","https://ap.wps.com/l/cbCairxi3HKpFccp","pdf",816553,"English","# Abstract\n# Introduction\n# Case Presentation\n# Test Result Reference range\n# Discussion","[{\"question\":\"Why is aortic dissection considered an emergency?\",\"answer\":\"Aortic dissection is life-threatening and requires prompt diagnosis and immediate management to prevent severe complications.\"},{\"question\":\"How did the case present atypically?\",\"answer\":\"The aortic dissection manifested solely as acute lower-limb ischemia, presenting with sudden pain in the left lower limb rather than typical chest pain.\"},{\"question\":\"What treatment and outcome are reported?\",\"answer\":\"The patient underwent surgery with resection of the ascending aorta and aortic arch and interposition of a Dacron graft; pulses in the left lower limb were restored postoperatively, and the patient was discharged after follow-up without sequelae.\"}]","Stanford Type A Aortic Dissection Manifesting as Acute Lower Limb Ischemia | PDF",1790578863,13]