The left and right iliac arteries transport blood through your pelvis and into your legs. Aortoiliac disease refers to a narrowing or blockage in either the aorta, the iliac arteries or both. This occurs when plaque builds up in the artery walls and reduces or stops the blood from flowing. Plaque is a sticky substance of cholesterol, calcium and fibrous tissue. Plaque can cause arteries to become narrow and stiff, a process called atherosclerosis—also known as hardening of the arteries.
Who is at Risk?
Risk factors for Aortoiliac disease include smoking, high cholesterol, high blood pressure, diabetes and a history of heart disease.
Symptoms of Aortoiliac Disease
● Pain, cramps or tiredness in the buttocks or legs during exercise or walking
● Erectile dysfunction
● Weak leg muscles
● Blue toe syndrome
Tests and Treatments
You may be given an Ankle-Brachial Index (ABI) test to compare the blood pressure in your ankle and your arm, which are normally the same. If the blood pressure in your ankle is significantly lower, that could be a sign of narrowing leg arteries. Ultrasound may be used to determine which arteries are blocked. Often, angiography is used to find the specific location and pattern of any blockages. Angiography helps specifically identify the best way to correct aortoiliac disease. Both MRA and CTA are also helpful in outlining the extent of aortoiliac disease.
Treatment options include exercise, changes to your diet, or medication. Smoking should be avoided entirely. If there is little improvement through these efforts, angioplasty or stenting may be performed to improve circulation. For more advanced cases, surgical bypass or endarterectomy may be necessary to improve blood flow. In some cases, a combination of open surgical technique and endovascular technique are used. Each patient should have their anatomy, symptoms and risks carefully analyzed to create a individualized treatment plan.