Aortoiliac Occlusive Disease Symptoms and Treatment

The Aortoiliac occlusive disease is diagnosed when there is a blockage in one of two major blood vessels:

1. The aorta, which is the body’s main blood vessel
2. The iliac arteries, which are located around the belly button and carry blood from the aorta to the pelvic organs and legs.

The Aortoiliac occlusive disease is the second-most common form of peripheral arterial disease (PAD). The most common form of PAD occurs in blood vessels in the thighs.

The disease is also known as Leriche, or Leriche’s, Syndrome after René Leriche, an early 20th-century physiologist and surgeon who provided a definitive diagnosis.

Not All Cases of Aortoiliac Occlusive Disease Show Symptoms

Because this disease affects a large part of the body ( the belly button in down), symptoms vary depending on where it’s taken hold. Or there may be none at all.

Many symptoms can be easily dismissed as occasional cramps. The exception is erectile dysfunction. This is often the only symptom of an early aortoiliac occlusive disease (AOD) in men younger than the typical age of diagnosis, 65 or higher.

AOD is most common in people who have already been diagnosed with atherosclerosis, or a hardening of the arteries. For this reason, I encourage these patients to be hyper-aware of these early symptoms of mild to moderate AOD:

• Problems with walking. Be aware of pain, cramps, or fatigue from walking. Fatigue is a little more unusual and easier to notice. If any of these occur outside normal activities, they should be reported to a physician for observation and diagnosis.

• Pale and/or cold legs. Hardening of the arteries interrupts blood flow to the lower extremities, particularly the legs. If the legs feel cold for no apparent reason, take that as a warning sign.

These AOD symptoms show up in the later stages of the disease:

• Severe pain in the legs or buttocks, even at rest
• Numbing in the feet or legs
• Weakness in leg muscles
• Sores on the legs or feet that aren’t healing

Get immediate treatment for these symptoms.

Medication and Behavior Changes are Key to Treating Treating Aortoiliac Occlusive Disease

Managing AOD—there is no cure—involves medication and encouraging behavior modification.

Medication for early stages of AOD can be as basic as aspirin therapy, although drugs that prevent platelets from clotting or statins to control cholesterol and prevent plaque development are often prescribed as well.

Behavior changes can be more difficult but are essential to prevent the disease from progressing. Physicians need to be supportive and encouraging with patients as we prescribe these modifications:

1. If you smoke, quit. Offer prescriptions for patches or gum. Patches are provided free by state trust funds set up after the tobacco firms’ settlement with the U.S. government.
2. Modify your diet to a heart-healthy one that minimizes LDL cholesterol and boosts HDL. Refer patients to a nutritionist if you don’t have one associated with your practice. Hand out heart-healthy recipes that include links to useful recipe websites.
3. Review diabetes management if the patient has been diagnosed. If s/he hasn’t, discuss diabetes prevention.
4. Prescribe a moderate exercise program. Low-impact exercise is a great way to get blood moving and prevent further disease progression. Regular swimming, walking (get a dog!) and chair yoga are all activities many seniors enjoy, and are distracting (or wet) enough to take the mind off eating or smoking.

Advanced AOD can be treated with surgery such as stent placement and surgical bypass. Atherectomy is a newer, minimally invasive technique that removes plaque within the vessel wall.

More information about PAD is on our website. Please feel free to contact us with questions about PAD or AOD treatment.