Aortoiliac occlusive disease

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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W8MD medical weight loss NYC and sleep center NYC

Aortoiliac occlusive disease
Diagram of the aorta and iliac arteries
Synonyms	Leriche syndrome
Pronounce	N/A
Specialty	N/A
Symptoms	Claudication, erectile dysfunction, leg pain
Complications	Critical limb ischemia, gangrene
Onset	Typically in middle-aged to elderly individuals
Duration	Chronic
Types	N/A
Causes	Atherosclerosis
Risks	Smoking, hypertension, diabetes mellitus, hyperlipidemia
Diagnosis	Ankle-brachial index, Doppler ultrasound, CT angiography, MR angiography
Differential diagnosis	Peripheral artery disease, spinal stenosis, deep vein thrombosis
Prevention	N/A
Treatment	Lifestyle modification, medication, angioplasty, bypass surgery
Medication	Antiplatelet drugs, statins, cilostazol
Prognosis	Variable, depends on severity and treatment
Frequency	Common in individuals with risk factors
Deaths	N/A

Illustration of Leriche's syndrome

Aortoiliac occlusive disease is a form of peripheral artery disease (PAD) that affects the aorta and the iliac arteries. It is characterized by the narrowing or blockage of these arteries, which can lead to reduced blood flow to the lower extremities. This condition is also known as Leriche syndrome when it presents with a specific set of symptoms.

Pathophysiology

Aortoiliac occlusive disease is primarily caused by atherosclerosis, a condition where plaque builds up on the inner walls of the arteries. This plaque is composed of lipids, cholesterol, calcium, and other substances found in the blood. Over time, the plaque hardens and narrows the arteries, reducing blood flow. In some cases, thrombosis or embolism can also contribute to the occlusion.

Symptoms

The symptoms of aortoiliac occlusive disease can vary depending on the severity of the blockage. Common symptoms include:

• Claudication: Pain or cramping in the buttocks, thighs, or calves during physical activity, which is relieved by rest.
• Erectile dysfunction: Often seen in male patients due to reduced blood flow to the pelvic region.
• Weakness or numbness in the legs.
• Coldness or pallor in the lower limbs.
• Gangrene or ulcers in severe cases.

Diagnosis

Diagnosis of aortoiliac occlusive disease typically involves a combination of clinical evaluation and imaging studies. Common diagnostic methods include:

• Ankle-brachial index (ABI): A simple test that compares the blood pressure in the ankle with the blood pressure in the arm.
• Doppler ultrasound: A non-invasive test that uses sound waves to measure blood flow in the arteries.
• Computed tomography angiography (CTA) or magnetic resonance angiography (MRA): Imaging techniques that provide detailed views of the blood vessels.
• Angiography: An invasive procedure that involves injecting a contrast dye into the arteries to visualize blockages.

Treatment

The treatment of aortoiliac occlusive disease aims to improve blood flow and relieve symptoms. Treatment options include:

• Lifestyle modifications: Such as smoking cessation, regular exercise, and a healthy diet to manage risk factors.
• Medications: Including antiplatelet agents, statins, and vasodilators to improve blood flow and reduce the risk of complications.
• Endovascular procedures: Such as angioplasty and stenting to open up narrowed arteries.
• Surgical interventions: Including bypass surgery or endarterectomy to remove blockages or create a new path for blood flow.

Prognosis

The prognosis for patients with aortoiliac occlusive disease depends on the severity of the disease and the effectiveness of treatment. With appropriate management, many patients can achieve significant symptom relief and improved quality of life. However, untreated or severe cases can lead to complications such as critical limb ischemia or amputation.

See also

• Peripheral artery disease
• Atherosclerosis
• Leriche syndrome
• Claudication
• Angioplasty