Aortoiliac occlusive disease is the blockage of your aorta, the main blood vessel in your body, or the iliac arteries. This blockage is typically caused by a buildup of plaque within the walls of your blood vessels. Your iliac arteries are the branches that your aorta divides into. These arteries provide blood to your legs and the organs in your pelvis. They are located just around your belly button.
You could have various symptoms or no symptoms at all and still have aortoiliac disease. Feeling fatigue, cramps, and pain in your buttocks, thighs or calves while walking may be a sign of having mild to moderate aortoiliac occlusive disease. As it progresses, you may experience these symptoms after walking a very short distance. This pain is known as claudication, and it goes away after you rest for a short while. If you are a man, you may experience erectile dysfunction as a symptom of aortoiliac disease. Experiencing pain at rest and other leg and feet problems is another symptom. If you have a severe case of aortoiliac disease you may feel pain in your feet or toes while you are at rest, a cold and numb feeling in your legs, and sores or wounds on your legs and feet. You may even experience gangrene or the death of tissue in your feet.
The most common known cause of aortoiliac disease is atherosclerosis. Atherosclerosis is a disease in which a waxy substance called plaque builds up in your arteries. This hardening of your arteries has several known causes:
- Smoking: The chemicals in tobacco smoke cause damage to your blood cells. These chemicals are known to damage your heart’s ability to function, and it affects the structure and functioning of your blood vessels. The damages caused by smoking increase your risk of atherosclerosis. If you smoke, do everything you can to kick the habit. Avoid other people’s secondhand smoke, too. If you already have atherosclerosis, smoking makes it worse.
- High Cholesterol: The two important types of cholesterol that you should know about are: low-density lipoprotein (LDL), or “bad” cholesterol, and high-density lipoprotein (HDL), or “good” cholesterol. The bad LDL cholesterol is the type of cholesterol found in the plaque that builds up in your arteries and causes atherosclerosis.
- High Blood Pressure: If your high blood pressure goes untreated plaque builds up inside your arteries (atherosclerosis). These blockages cause problems and coronary heart disease once they start occurring in the arteries that supply blood to your heart muscle.
- Genetic Predispositions: If your family has a history of atherosclerosis, you are more likely to develop it.
- Obesity: Losing weight doesn’t just make you look and feel good. It does good things for your arteries. You need some fat to be healthy. But, if you have too much fat, the lining of your arteries won’t work properly. This makes atherosclerosis more likely to develop. Having too much fat will also raise your risk of developing blood clots, which are known to lead to having a stroke or heart attack.
Being active and eating healthy foods can give you so many things:
- Healthier Blood Vessels
- Lower Blood Pressure
- Higher “good” (HDL) cholesterol levels
- Lower “bad” (LDL) cholesterol levels
- Lower Chance of Type 2 Diabetes
Ask your doctor about what your goal weight should be, what diet guidelines and levels of salt and fat they recommend. It is also your responsibility to find out what types of exercise are right for you to do.
Your vascular specialist or surgeon will ask you questions about your symptoms and medical history, including questions about your family members and their health conditions. A physical exam will also be performed. Then a series of diagnostic tests will possibly be recommended:
- Ankle-Brachial Index Test: Compares the blood pressure of your wrist and your ankle.
- Duplex Ultrasound: Examines the quality of your blood flow
If further testing is needed, there are additional studies that can be performed. These studies use various types of dyes to help your doctor identify where blockages in your arteries are located:
- CT Angiogram
- MR Angiogram
- With a CT angiogram and MR angiogram, the dye is delivered through an IV.
- Catheter-Directed Angiogram: Dye is injected through a thin tube (catheter) and then inserted into your artery.
Aortoiliac occlusive disease can be managed by doing the following:
- Medication: Aspirin or a prescription medication that prevents platelets from clotting in your blood. A statin drug can sometimes help control your cholesterol and prevent plaque progression in your arteries.
- Risk Factor Modification: Quit smoking and control your high blood pressure and cholesterol levels. Manage your diabetes and get regular amounts of healthy, good exercise.
If your need further treatment, a minimally invasive procedure like a stent placement or an angiogram may be needed. Sometimes a surgical bypass is a way to go. A stent is a small device that pushes the plaque against the walls of your arteries and creates a wider path for blood to flow to the lower half of your body. Angioplasty (where an inflatable balloon device is inserted through the catheter to further assist in opening up your arteries) can be added to stent placement. Surgical bypass surgery involves the creation of a detour that goes around the blockage. This detour may start in your aorta (near your heart) and ends either in your iliac arteries in your pelvis, or in an artery in your groin.
Talk with your doctor about getting tested for atherosclerosis and aortoiliac disease. If you catch and treat it early, you could save yourself from suffering its debilitating symptoms.
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