Vascular Specialists Tyler Texas
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Non-Invasive Abdominal Vascular Evaluation:
Aortoiliac Occlusive Disease (Test)

What is an abdominal vascular examination?

When you have a abdominal vascular examination for aortoiliac occlusive disease at Vascular Specialists of East Texas, it will consist of the following tests:

Ankle brachial index (ABI)

An ABI is performed by measuring blood pressures at a single level.  Arterial pressures in the lower extremities at the ankle and toes are compared to the pressures measured in the arms. This is reported as a ratio and used as an indicator for peripheral arterial disease (PAD).

Aortoiliac Duplex

Vascular studies are noninvasive (the skin is not pierced) procedures used to evaluate the blood flow in arteries and veins and to assess for blockage or stenosis. Plaque (a build up of fatty materials), a thrombus (blood clot), and other substances in the blood stream may cause a disturbance in the blood flow through the arteries. This procedure combines high resolution B-mode real-time imaging with Doppler ultrasound, color flow Doppler and spectral analysis. Ultrasound creates an image of the structure of the tissues and arteries and Doppler demonstrates the characteristics of the blood flow through the arteries. You will be able to hear the Doppler portion of the study. Gel will be placed on your skin to conduct the sound waves from the transducer.

What is aortoiliac occlusive disease?

Aortoiliac occlusive disease occurs when your aorta and/or iliac arteries become narrowed or blocked. The aorta, your body's main artery, splits into branches at about the level of your belly button. These branches are called the iliac arteries. The iliac arteries go through your pelvis into your legs, where they divide into many smaller arteries that run down to your toes. Aortoiliac disease is considered a type of peripheral arterial disease (PAD) because it affects arteries, which are blood vessels that carry blood away from your heart to your limbs.

Your arteries are normally smooth and unobstructed on the inside, but as you age, a sticky substance called plaque can build up in the walls of your arteries. Plaque is made up of cholesterol, calcium, and fibrous tissue. As more plaque builds up, it causes your arteries to narrow and stiffen. This process is called atherosclerosis, or hardening of the arteries. Eventually, enough plaque builds up to interfere with blood flow in your iliac arteries or leg arteries. Physicians call this aortoiliac occlusive disease because it involves the aortoiliac arteries.

When your iliac arteries narrow or become blocked, your legs may not receive the blood and oxygen they need. This lack of oxygen is called ischemia and it can cause pain. In severe cases, sores or gangrene can develop, which can result in losing a limb. However, these developments are uncommon unless the process is not treated and is allowed to progress.

What are the indications or symptoms for an abdominal vascular evaluation for aortoiliac disease?

Early in the disease, you may feel pain, cramping, or fatigue in your lower body when you walk or exercise. The pain with walking usually occurs in your buttocks, thighs, and legs. This symptom is called intermittent claudication because it stops when you rest. As the disease worsens, you may find that pain occurs when you walk for shorter distances. Ultimately, as the disease progresses, you may feel pain, usually in your toes or feet, even when you are resting.
Some men who have aortoiliac occlusive disease also experience erectile dysfunction, the inability to have or maintain an erection.
Aortoiliac disease may worsen if it is not treated. Signs that it has advanced include:

  • Severe pain, coldness, and numbness in a limb
  • Sores on your toes, heels, or lower legs
  • Dry, scaly, cracked skin on your foot. Major cracks, or fissures, may become infected if left untreated
  • Weakened muscles in your legs
  • Gangrene (tissue death), which may require amputation

What causes aortoiliac occlusive disease?

  • Atherosclerosis, or hardening of the arteries, causes most cases of aortoiliac occlusive disease.
  • Risk factors for hardening of the arteries include:
    • Smoking
    • High cholesterol levels in the blood
    • High blood pressure
    • Obesity
    • Having a family history of heart disease

What can I expect during the exam?

A complete examination of the aorta and iliac arteries is approximately 45 to 60 minutes.  It is performed in a darkened room lying on an exam table. A technologist will place pressure cuffs on the arms, legs, and toes to perform the blood pressures of the extremities. For the abdominal arterial duplex exam, images of the arteries will be taken using the ultrasound equipment.  A transducer is placed on the skin with a small amount of water soluble ultrasound gel. 

Patient Instructions

  • Allow 45 to 60 minutes for your abdominal vascular examination.
  • No smoking for one hour prior to study - it can create a constriction of your arteries and increase abdominal gas.
  • Fast for at least 8 hours before the scan -to limit any excess bowel gas which may otherwise restrict the view.
  • Please notify us if you suffer from diabetes and we will try and accommodate you with an early morning appointment.
  • Unless specified, you should take your usual medications with a small amount of water.


Please call us with questions or to schedule an appointment.

Vascular Specialists of East Texas