Aortoiliac Occlusive Disease

Basic Facts

  • Aortoiliac Occlusive Disease (AOD) is the narrowing or blockage of the main arteries in the pelvis, which supply blood to the legs. It is a type of peripheral arterial disease.
  • Atherosclerosis is the hardening of the arteries that occurs when fatty plaque builds up inside artery walls, causing AOD.
  • AOD (sometimes called aortoiliac disease) refers to disorders of the two blood vessels (the aorta and the iliac artery) that supply blood to the lower half of the body. The aorta carries oxygenated blood and nutrients from the heart to the rest of the body, splitting into two branches near the belly button. These branches (the iliac arteries) travel into the legs, where they branch into a number of smaller arteries that run to the toes.
  • AOD most often occurs where the aorta and iliac arteries meet, but it can also appear in the lower abdominal aorta and in the iliac arteries. Narrowing or blockage of these arteries by plaque buildups prevents the leg muscles from receiving enough oxygen and nutrients. A decreased supply of oxygen can lead to severe pain or break down in the tissue in the foot, producing sores (ulcers) or gangrene.

Symptoms

The primary symptoms of AOD are pain, cramping, or tiredness that occurs when a person exercises (but stops when the person is at rest). This pain (called, intermittent claudication) usually strikes in the buttocks, thighs, and legs. Men who have AOD may also experience erectile dysfunction. As the disease progresses, more severe symptoms may appear, including:

  • Pain, coldness, and numbness in the legs (even while at rest)
  • Sores on the toes, heels, or lower leg
  • Muscle atrophy (shrinkage)
  • Gangrene

Causes & Risk Factors

The primary cause of AOD is atherosclerosis (or, hardening of the arteries due to plaque buildup). When plaque deposits narrow the aorta and iliac arteries, the vessels are unable to deliver adequate blood to the pelvic organs and legs. Risk factors for aortoiliac disease include:

  • Smoking
  • High blood pressure (hypertension)
  • High blood levels of cholesterol or other lipids (fats)

Diagnosis

To diagnose AOD, a physician may order a variety of tests. Tests include:

  • Pulse tests
  • Blood pressure testing in the leg
  • Doppler ultrasound
  • Arteriography (a contrast dye is injected into the arteries and x rays are taken)

Treatment Options

Treatments for AOD depend on the severity of the disease.

In mild to moderate cases, treatment may require the patient to:

  • Adopt lifestyle changes (like quitting smoking, exercising regularly, and reducing dietary fat)
  • Receive foot care from a qualified healthcare professional (to prevent injuries and ulcerations that could progress to gangrene and result in amputation)
  • Take medications that reduce blood clotting and increase blood flow

In severe cases, any number of surgical treatments may be required:

  • Angioplasty
  • Stenting
  • Atherectomy catheterization (a catheter with an attached drill or laser removes plaque within the artery)
  • Bypass surgery
  • Amputation (in very severe cases)

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Medical Review Date: June 15, 2005 / Copyright © 2012 NorthPoint Domain, Inc. All rights reserved. This material cannot be reproduced in digital or printed form without the express consent of NorthPoint Domain, Inc. Unauthorized copying or distribution of NorthPoint Domain’s Content is an infringement of the copyright holder’s rights.