Aortoiliac Occlusive Disease

Basic Facts

Aortoiliac occlusive disease is the narrowing or blockage of the main arteries in the pelvis, which supply blood to the legs. It is a type of peripheral arterial disease.
Atherosclerosis, the hardening of the arteries that occurs when fatty plaque builds up inside artery walls, causes aortoiliac occlusive disease.
The primary symptoms of aortoiliac disease are pain, cramping, tightness, numbness, or tiredness in a person’s hips, thighs, or buttocks when he or she walks or exercises. These symptoms stop when the person is at rest.

Aortoiliac occlusive disease, sometimes called aortoiliac disease, refers to disorders of the two blood vessels that supply blood to the lower half of the body.the aorta and the iliac artery. The aorta carries oxygenated blood and nutrients from the heart to the rest of the body, splitting into two branches at about the level of the belly button. These branches, the iliac arteries, travel into the legs, where they branch into numerous smaller arteries that run to the toes.

Aortoiliac occlusive disease most often occurs where the aorta and iliac arteries meet, but it also appears in the lower abdominal aorta and the iliac arteries. Narrowing or blockage of these arteries prevents the leg muscles from receiving enough oxygen and nutrients. A decreased supply of oxygen is called ischemia, which may cause severe pain or break down tissue in the foot, producing sores (ulcers) or gangrene.

Atherosclerosis: Plaque deposits thicken and narrow the arteries.


The primary symptoms of aortoiliac disease are pain, cramping, or tiredness that occur when a person exercises but stop when the person rests. This pain, called intermittent claudication, usually strikes the buttocks, thighs, and legs. Men who have aortoiliac disease may also experience erectile dysfunction.

As the disease progresses, more severe symptoms may appear, including:

  • Pain, coldness, and numbness in the legs, even at rest;
  • Sores on the toes, heels, or lower leg;
  • Muscle atrophy (shrinkage); and
  • Gangrene.


The primary cause of aortoiliac disease is atherosclerosis, or hardening of the arteries. When plaque deposits narrow the aorta and iliac arteries, the vessels are unable to deliver adequate blood to the pelvic organs and legs.

Risk factors for aortoiliac disease include:

  • Smoking;
  • High blood pressure (hypertension); and
  • High blood levels of cholesterol or other lipids (fats).


To diagnose aortoiliac disease, a physician may order a variety of tests, including:

  • Pulse tests;
  • Blood pressure testing in the leg;
  • Doppler ultrasound; and
  • Arteriography, in which a contrast dye is injected into the arteries and x rays are taken.


Treatments for aortoiliac disease depend on the severity of the disease. Mild to moderate cases may require the patient to:

  • Adopt lifestyle changes like quitting smoking, exercising regularly, and reducing dietary fat;
  • Receive foot care from a qualified healthcare professional to prevent injuries and ulcerations that could progress to gangrene and result in amputation; and
  • Take medications that reduce blood clotting and increase blood flow.

Because of the consequences of severe, disabling aortoiliac disease, physicians often recommend surgical treatments, such as:

  • Angioplasty;
  • Stenting;
  • Atherectomy catheterization (A catheter with an attached drill or laser removes plaque within the artery); and
  • Bypass surgery.