Aortoiliac Occlusive Disease

Aortoiliac occlusive disease occurs when your iliac arteries become narrowed or blocked. The aorta, your body’s main artery, splits into branches at about the level of your belly button. These branches are called the iliac arteries. The iliac arteries go through your pelvis into your legs, where they divide into many smaller arteries that run down to your toes. Aortoiliac disease is considered a type of peripheral arterial disease (PAD) because it affects arteries, which are blood vessels that carry blood away from your heart to your limbs.

Your arteries are normally smooth and unobstructed on the inside, but as you age, a sticky substance called plaque can build up in the walls of your arteries. Plaque is made up of cholesterol, calcium, and fibrous tissue. As more plaque builds up, it causes your arteries to narrow and stiffen. This process is called atherosclerosis, or hardening of the arteries. Eventually, enough plaque builds up to interfere with blood flow in your iliac arteries or leg arteries. Physicians call this aortoiliac occlusive disease because it involves the aortoiliac arteries.

When your iliac arteries narrow or become blocked, your legs may not receive the blood and oxygen they need. This lack of oxygen is called ischemia and it can cause pain. In severe cases, sores or gangrene can develop, which can result in losing a limb. However, these developments are uncommon unless the process is not treated and is allowed to progress.

What causes aortoiliac occlusive disease?

  • Atherosclerosis, or hardening of the arteries, causes most cases of aortoiliac occlusive disease.
  • Risk factors for hardening of the arteries include:
    • Smoking
    • High cholesterol levels in the blood
    • High blood pressure
    • Obesity
  • Having a family history of heart disease

What are the symptoms?

Early in the disease, you may feel pain, cramping, or fatigue in your lower body when you walk or exercise. The pain with walking usually occurs in your buttocks, thighs, and legs. This symptom is called intermittent claudication because it stops when you rest. As the disease worsens, you may find that pain occurs when you walk for shorter distances. Ultimately, as the disease progresses, you may feel pain, usually in your toes or feet, even when you are resting.

Some men who have aortoiliac occlusive disease also experience erectile dysfunction, the inability to have or maintain an erection.

Aortoiliac disease may worsen if it is not treated. Signs that it has advanced include:

  • Severe pain, coldness, and numbness in a limb
  • Sores on your toes, heels, or lower legs
  • Dry, scaly, cracked skin on your foot. Major cracks, or fissures, may become infected if left untreated
  • Weakened muscles in your legs
  • Gangrene (tissue death), which may require amputation

If you experience any of these advanced symptoms, it usually means that your leg arteries are blocked in more than one place. Your physician may need to treat more than one site to prevent gangrene or limb loss.