Aortoiliac Occlusive Disease

Aortoiliac Occlusive Disease is the blockage of the aorta, the main blood vessel in your body, or the iliac arteries. The iliac arteries are the branches that your aorta divides into provide blood to your legs and the organs in your pelvis. This blockage is typically caused by a buildup of plaque within the walls of your blood vessels.

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

Diagnosis

SEE A VASCULAR SURGEON
You will be asked questions about symptoms and medical history, including questions about family members. The vascular surgeon will also perform a physical exam.

TESTS MAY BE RECOMMENDED
Initially an ankle-brachial index test and a duplex ultrasound may be recommended.
Further testing may be needed and your surgeon may prescribe an angiogram (catheter directed injection of IV dye and X-ray imaging), a CT angiogram or MR angiogram.
These tests use different types of dye to help identify where blockages in the arteries are located to plan further treatment. With a CT angiogram and MR angiogram, dye is delivered through an IV placed in your arm. With a catheter-directed angiogram, dye is injected through a thin tube (catheter) inserted in an artery (typically in your groin or arm).

Treatments

Risk factor modification, such as quitting smoking, controlling cholesterol or high blood pressure, managing diabetes and regular exercise.
Medication may be prescribed, such as an aspirin or another medication to prevent platelets from clotting in the blood. A statin drug may help control cholesterol and also help prevent plaque progression.

If further treatment is needed, a minimally invasive procedure or a surgical bypass may be considered.

The most common minimally invasive treatment generally includes balloon angioplasty and placement of a stent in your aorta or iliac arteries. This procedure is commonly done at the same time as a catheter-directed angiogram test. A stent is a small device that compacts the plaque against the walls of the arteries to create a wider path for blood flow to the lower half of your body. An angioplasty, in which an inflatable balloon device is inserted through the catheter to further assist in opening up the arteries.