SYMPTOMS

Symptoms of aortoiliac occlusive disease vary widely. In its earliest stages, you may experience fatigue, pain, or cramping when walking. Erectile dysfunction is common in males with the condition. As the disease progresses, symptoms may occur after walking very short distances. Men may also experience pain at rest and problems with their legs and feet—including coldness, numbness, sores or wounds on their legs and feet, as well as gangrene or the death of tissue in their feet.

CAUSES

Aortoiliac disease is usually caused by atherosclerosis, which can be accelerated by smoking, high cholesterol, high blood pressure, a genetic predisposition or obesity. Inflammatory conditions such as Takayasu’s arteritis may also cause inflammation in the arteries leading to blockages of the arteries. Radiation treatment to the pelvis can cause progressive inflammation in the arterial wall as well.

DIAGNOSIS

Initial tests may include an ankle-brachial index test and duplex ultrasound. If further testing is needed, a CT angiogram, MR angiogram, or catheter-directed angiogram may be recommended. These studies use different types of dye to help identify where blockages in the arteries are located to plan further treatment.

TREATMENTS

Risk Factor Modifications

Risk factor modification may include smoking cessation, control of cholesterol, high blood pressure and diabetes control, exercise and medication to prevent blood from clotting. Medication such as aspirin or a statin drug may be prescribed to help control cholesterol and also help prevent plaque progression.

Minimally Invasive Stent Placement 

The most common minimally invasive treatment for atherosclerosis is the placement of a stent in your aorta or iliac arteries. A catheter-directed angiogram test can also be done at the same time as the stent placement. The stent compacts the plaque against the walls of the arteries to create a wider path for blood flow to the lower half of your body. An angioplasty, in which an inflatable balloon device is inserted through the catheter to further assist in opening up the arteries, can be added to this treatment if needed.

Surgical Bypass

A surgical bypass, or angioplasty, is a procedure to increase the flow of blood around an area of blockage in your body. In the case of leg blockages, bypasses are typically performed on both sides at once. For severe disease requiring surgery, bypasses are often done from the aorta to the groin. If there is not a suitable artery in the groin area, or if you do not feel that you are healthy enough for aortic surgery, your bypass will usually start at your axillary artery (underneath your collarbone) and end in one or both legs.