Aortoiliac Occlusive Disease

Aortoiliac occlusive disease is a type of vein condition in the legs. It occurs when the iliac artery that brings blood to your legs becomes narrow or blocked by plaque. Symptoms can include pain, numbness, or cramping in the lower limbs, gangrene in the feet, and erectile dysfunction (ED) in men. Common treatments for aortoiliac occlusive disease include drugs, exercise, and surgery.

At the UPMC Division of Vascular Surgery, our experts take a team approach to diagnosing and treating aortoiliac occlusive disease.

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What Is Aortoiliac Occlusive Disease?

Your aorta is your main blood vessel. It comes out from your heart, down through your chest, and into your belly. There, it branches off into your iliac arteries.

Your iliac arteries bring blood down into your legs.

Aortoiliac occlusive disease is a type of peripheral artery disease (PAD).

It happens when your aorta and iliac arteries become narrow or blocked by:

  • Plaque — a hard substance made of cholesterol
  • Fatty deposits
  • Calcium
  • Other substances in your blood.

As plaque builds up, it causes the arteries to narrow and harden, slowing — and even stopping — blood flow.

Aortoiliac occlusive disease causes and risk factors

Atherosclerosis — or hardening of the arteries — is a leading cause of aortoiliac occlusive disease.

Some risk factors for atherosclerosis include:

  • High cholesterol
  • High blood pressure
  • Smoking
  • Diabetes
  • Being overweight or obese
  • Not getting enough exercise
  • Eating an unhealthy diet
  • Having a family history of heart and vascular disease
  • Inactive lifestyle

Another cause can include radiation to the pelvis. This may lead to inflammation in the arteries and progression of PAD.

Aortoiliac Occlusive Disease Symptoms and Diagnosis

Symptoms of aortoiliac occlusive disease

Aortoiliac occlusive disease develops over a lifetime with varying symptoms.

Symptoms of mild to moderate aortoiliac occlusive disease include:

  • Fatigue, pain, or cramping in the buttocks, thighs, or calves when walking.
  • Erectile dysfunction in men.

Symptoms of severe aortoiliac occlusive disease can include:

  • Pain in your feet or toes at rest.
  • Coldness or numbness in your legs.
  • Leg or foot ulcers (sores that don't heal).
  • Tissue loss (gangrene) in your feet.

Diagnosing aortoiliac occlusive disease

To diagnose aortoiliac occlusive disease, your UPMC vascular surgeon will:

  • Ask you about your symptoms.
  • Review your medical history.
  • Perform a physical exam.

Your doctor may also use the following tests to confirm a diagnosis of aortoiliac occlusive disease:

  • Ankle-brachial index — measures your blood pressure at your ankles and your arms.
  • Duplex ultrasound — uses sound waves to make moving pictures of your blood vessels.
  • Computerized tomographic (CT) scan — uses cross-sectional x-rays and a computer to make detailed 3D pictures.
  • Magnetic resonance imaging (MRI) — uses a large magnetic field, radio waves, and computers to make detailed pictures of your arteries.

Aortoiliac Occlusive Disease Treatment

Treatment for aortoiliac occlusive disease will depend on the severity and extent of your condition.

Treatments for mild aortoiliac occlusive disease

For mild forms of aortoiliac occlusive disease, treatments can include:

  • Drugs that help prevent blood clots or lower your cholesterol level.
  • Lifestyle changes, like:
    • Regular exercise and walking.
    • Quitting smoking.
    • Managing high cholesterol, high blood pressure, and diabetes.

Treatments for more severe aortoiliac occlusive disease

For more advanced forms of aortoiliac occlusive disease, treatments can include:

  • Angioplasty and stenting, which uses a balloon to open the artery and a metal mesh tube to hold it open.
  • Surgery to bypass the blocked arteries.