Aortoiliac Occlusive Disease

Definition

Aortoiliac occlusive disease is considered a type of peripheral arterial disease (PAD). It occurs when the iliac arteries that deliver blood and oxygen to your legs become narrowed or blocked by from a buildup of plaque (cholesterol, calcium, and fibrous tissue), limiting the supply of blood to your legs.

PAD occurs in 12-20% of people over the age of 65.

Early symptoms of aortoiliac occlusive disease can include pain, numbness, or cramping in the lower body; gangrene; and erectile dysfunction (ED) in men.

Advanced symptoms generally indicated that arteries in the leg may have multiple blocks. These symptoms can include:

  • Severe pain, coldness, and numbness in your limbs

  • Sores on your feet or lower legs

  • Weakened muscles

  • Cracks or fissures on your feet

  • Gangrene (tissue death) – may result in limb loss if untreated

Atherosclerosis or hardening of the arteries is most often the cause of aortoiliac occlusive disease. Risk factors include smoking, high cholesterol, high blood pressure, obesity, and a family history of heart disease. A rarer cause is Takayasu’s arteritis that affects Asian women, 10-30 years of age. 

  • Medical exam and patient history

  • A check of your pulse points

  • Ankle-Brachial Index (ABI) – Non-invasive blood pressure measurements in ankle and arm. A comparison of the two numbers yields your ABI.

  • Doppler Ultrasound – This is used to better identify specific blocked arteries. It is a non-invasive test that uses high-frequency sound waves to show blood flow and the structure of blood vessels.

  • Angiography – This can consist of contrast arteriography, CT angiography (CTA), or MR Angiography (MRA) tests.

    • Contrast arteriography uses contrast dye and x-ray. It is more invasive but provides a better resolution to pinpoint exact locations and patterns of blockage. Results may indicate an angioplasty and/or a stent could be required.

    • CTA and MRA scans are used to evaluate blood vessels

Lifestyle Changes (for mild to moderate cases)

  • Quit Smoking – Chemicals in tobacco can damage arteries

  • Reach/Maintain Healthy Weight – Structured walking program, low-fat/high-fiber diet

  • Improve Foot Care – Especially critical for diabetes patients

Medications

No medication will cure this disease. However, prescribed medications may assist in managing symptoms and advancement of the disease, as well as reduce the odds of blood clots. Statins may be prescribed as an option to control cholesterol levels.

Angioplasty Stenting

When medications and lifestyle changes aren’t enough, angioplasty may be recommended to restore circulation in your legs. If needed, a tiny stent (mesh-metal tube) may also be inserted to ensure the narrowed area remains open.

Surgery

Surgical options include surgical bypass to create a detour using an incision and grafts to restore blood flow or an endarterectomy to remove plaque from the inner lining of the diseased artery.

You can depend on the expert team of medical professionals at Vascular Tyler to help you determine your best treatment options, based on your test results.

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The Patient Experience

Dr. Robbins looked at my imaging and made an appointment that same day for me to come in. At Vascular Tyler, it’s just like a family environment every time I come in here. If I have to go the doctor’s (office), this is where I want to go.
L. Cunningham, Patient
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B. Finch, Patient
I had excruciating pain and was told I needed a knee replacement. But Dr. Robbins said I just need vascular surgery. They gave me relief from my pain, and they’re kind and interested in you as a patient and a person. This is the place to come.
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