What is Aortoiliac Occlusive Disease? Are you experiencing reduced blood flow to your legs? Let's talk about this!

Do you sometimes have leg pain when you walk? Does the pain subside after standing for a while? Or do you feel numbness or coldness in your legs? These could be signs of something serious. Today we are going to talk about a condition called `Aortoiliac Occlusive Disease`, which has a somewhat complicated name, but can affect many people. Don't worry, let's explain this simply.

What is Aortoiliac Occlusive Disease?

Simply put, this is a blockage in the main blood vessel that supplies blood to the lower part of our body. This condition belongs to a large group of diseases called `Peripheral Artery Disease (PAD),` which refers to the blood vessels that supply blood to the limbs.

This disease mainly affects the lower part of the `(Aorta)`, the largest blood vessel in our body, and the blood vessels called `(Iliac arteries)`. The `(Aorta)` is the main artery that carries blood from the heart through the chest to the abdomen. The `(Iliac arteries)` are the two main branches of this `(Aorta)` that divide in two near the abdomen and carry blood to the legs.

Now, what happens in this disease is that something called `(Plaque)` builds up inside these blood vessels. `(Plaque)` is a sticky substance that is made up of things like oil and cholesterol. Imagine, this is something like rust and dirt building up inside a water pipe in our house over time.

There are two reasons why this `(Plaque)` is dangerous:

• Reduces the space inside the blood vessels: As this `(Plaque)` builds up, the space inside the blood vessels becomes smaller. Then the blood flow becomes blocked, like a traffic jam.
• Can cause an `(Embolus)`: Sometimes a piece of this `(Plaque)` can break off and travel with the blood. A piece that breaks off like this is called an `(Embolus).` If this `(Embolus)` gets stuck somewhere in a small blood vessel, the blood flow from there will stop completely.

How does this affect our bodies?

Aortoiliac Occlusive Disease is a condition in which the blood flow in the Aorta and Iliac arteries is obstructed. This causes various problems because oxygenated blood does not reach the tissues of our body properly. To understand this, you need to know a little about these blood vessels.

Our `(Aorta)` is like a main road in a city. From this main road, many side roads take blood to different parts of the body. For example, the `(Renal arteries)`, which supply blood to our kidneys, split off from the `(Aorta).` This split is the upper limit where `(Aortoiliac Occlusive Disease)` can begin. Doctors call the part of the `(Aorta)` below these `(Renal arteries)`, up to the navel, the `(Infrarenal aorta)`.

Now, at the base of the skull, this `(Aorta)` splits into two , like an upside-down 'Y' . These are the two blood vessels called the right and left `(Common iliac artery)`. These branches further divide and supply blood to the following parts of our body:

• Buttock area
• Legs and feet
• Hip area
• Parts of the male and female reproductive system
• Organs of the pelvic cavity (e.g., bladder, liver)

The severity of the disease depends on which part of this 'Y' is blocked and how badly it is blocked. Sometimes, if only a small area is blocked, there may be no major symptoms. This is because blood can travel to some extent through other small veins. But if it is blocked extensively, the symptoms are more severe and the chances of complications are higher.

Who is most likely to develop this disease?

It is estimated that this disease affects more than 6 million people over the age of 40 in the United States alone. The risk of developing it increases with age. For example, about 5% of people in their 50s have it, but more than 20% of people in their 80s may have it. Also, this condition is more common in men and in black people.

Could this be life-threatening?

Yes, if not treated properly, Aortoiliac Occlusive Disease can lead to serious, sometimes life-threatening complications. These are the main ones that can occur:

• Amputation: This means cutting off and removing a part of the body, such as a leg. This happens because the tissue dies when the blood supply is cut off.
• `(Heart attack)` (Heart attack): A heart attack.
• `(Heart failure)` (Heart failure): Heart failure.
• `(Gangrene): The death and decay of tissue.

Therefore, it is very important to pay attention to these symptoms.

What are the symptoms?

Some people may not have any symptoms at all. However, if they do have symptoms, they may include:

• Erectile dysfunction (ED): The inability of men to achieve or maintain an erection during sexual intercourse. This can also be associated with this disease.
• `(Intermittent claudication)` (Intermittent claudication): This is a major symptom that many people experience. When exercising, for example, while walking, there is pain, tightness, or stiffness in the buttocks or legs. It subsides after a while of rest. Imagine that in our village, when Uncle Somapala goes to the shop, after walking a short distance, he stops and says, "Ah, my leg!", and after a while, he goes again. That's a similar situation.
• Rest Pain: Pain in the legs that wakes you up at night. This pain can occur especially when your legs are elevated, as gravity reduces the blood flow down the legs.
• Ulcers: Non-healing wounds on the skin, known as ulcers, can be seen on the legs or soles of the feet.

If you have any of these symptoms, you should definitely see a doctor. Because if you recognize the signs of `Aortoiliac Occlusive Disease` early, it is easier to treat.

Your doctor will also check for problems with blood flow in other parts of your body, such as the carotid arteries in your neck or the coronary arteries in your heart. Usually, if plaque builds up in one part of your body, it's likely to be in other parts as well.

Emergency: Acute Arterial Occlusion

However, sometimes, when the condition becomes severe, an emergency called ``Acute arterial occlusion'' can occur. This means that part of your body, most often a leg or foot, is deprived of oxygen-rich blood. This is a medical emergency that requires immediate medical attention! This is called the 'six Ps' and has a few symptoms:

• Pain: An unbearable, intense pain . This is the first thing you feel.
• Pallor: The skin on the affected leg becomes very pale.
• Pulse deficit: The pulse in that area is very weak, or not felt at all.
• Poikilothermia (coldness): When touched, that leg feels colder than the other.
• Paresthesia (numbness): It feels like your leg is numb, like ants are running around, or like pins and needles .
• Paralysis: The affected limb cannot be felt or moved.

If you experience any of these symptoms, call 911 or go to the nearest hospital emergency department immediately! Every minute counts. The longer the blood flow is blocked, the more tissue damage occurs. In severe cases, amputation or even death may occur.

What are the reasons for this?

The main cause of this `Aortoiliac Occlusive Disease` is a condition called `(Atherosclerosis)` . Simply put, this means that the previously mentioned `(Plaque)` gradually builds up inside the blood vessels of the body. In this disease, that `(Plaque)` gets deposited in the lower part of the `(Aorta)` and the `(Iliac arteries)`.

Apart from that, there may be several other rare reasons:

• If you have had radiation treatment to the pelvic area.
• Inflammation of the blood vessels, a condition called ``Vasculitis''.

What are the risk factors?

Since anyone can develop atherosclerosis, anyone can develop this disease. However, certain things increase the risk:

• Aging: The risk increases with age.
• Family history: If anyone in your family has Peripheral Artery Disease (PAD), tell your doctor about it.
• Smoking: This is a major risk factor! Smoking is a major risk factor for this disease, as well as other vascular diseases. If you are a smoker, it is very important to seek help to quit.
• Some medical conditions:
• `Diabetes`
• High blood pressure
• `High cholesterol`
• `Takayasu's arteritis` (this is also a rare condition that affects the blood vessels)

How to diagnose the disease?

If you have any of these symptoms, the first thing you should do is see a doctor. Your doctor will do the following to diagnose the condition or rule out another cause:

1. Asks you questions:

• What are your symptoms?
• Since when have these been around?
• When do you feel these the most?
• Does it decrease when you do something?
• Are the symptoms getting worse?
• Does anyone in your family have this kind of illness?
• What other illnesses do you have?

2. Performs a physical examination: Check your general health.

3. Performs several tests:

• Ankle-brachial index (ABI): This is a simple, painless test. The blood pressure in your arms and legs is measured and compared. This gives a rough idea of ​​how well blood is flowing to your legs and feet.
• Blood tests: These can help you check things like cholesterol and sugar levels, as well as your risk factors for heart and blood vessel disease, and your general health.
• `(Computed tomography angiogram (CTA))`: This is a special `CT scan`. It can clearly see things like where `(plaque)` is inside the blood vessels and how blocked they are.
• Vascular ultrasound (also called Doppler scan): This also uses ultrasound waves to look at the way blood flows inside the blood vessels and to see if there are any blockages.

What are the treatments?

Treatment depends on the severity of your condition. Sometimes lifestyle changes and medications can help control the condition and slow the progression of the disease. Your doctor may recommend the following:

• Antihypertensive medication .
• Antiplatelet medication, such as aspirin or clopidogrel, is a medication that reduces the risk of blood clots .
• Dietary changes: Following a healthy diet, such as the Mediterranean diet or the DASH diet, can help control risk factors such as diabetes and cholesterol.
• Exercise: Regular exercise as directed by your doctor can reduce many risk factors and improve blood flow to your legs.
• Special medications (e.g., Cilostazol) for leg pain that occurs when walking (`Intermittent claudication`).
• Cholesterol-lowering medications (`Statins`).
• Quitting smoking and using tobacco products completely is a must.

If these things don't control the disease, you may need things like:

• Bypass surgery: A new route is created to bypass the blocked blood vessel. This is similar to a coronary artery bypass. The location of the blockage and where the bypass begins and ends may vary depending on your health condition.
• `(Stent placement)`: A small mesh-like `(Stent)` is placed inside the blocked blood vessel to widen it. This improves blood flow. Doctors can use `(Endovascular)` methods, which means inserting this `(Stent)` through a small hole without making a large incision.

Every treatment has its pros and cons, so it's best to discuss all of this with your doctor and decide which treatment option is best for you.

Can this disease be prevented?

It may not be possible to completely prevent it, but there are many things we can do to reduce the risk:

• Quit smoking and all tobacco products.
• Eat a heart-healthy diet low in saturated fat, cholesterol, salt, and sugar.
• Exercise regularly as directed by your doctor.
• Control your blood pressure, blood sugar levels, and cholesterol levels.
• Take the medicine prescribed by the doctor on time.
• Get a medical checkup at least once a year.

If you have risk factors for this disease or atherosclerosis, talk to your doctor. The sooner you start controlling your risk factors, the better your chances of preventing serious complications later.

What happens if I have this disease?

To know for sure about your condition, you should talk to your doctor. Treatments like ``Bypass surgery`` and ``Stent placement`` are usually successful and the results are long-lasting. Your doctor will tell you more about what to expect from your treatment plan.

How do I take care of myself?

It's important to follow your doctor's instructions regarding lifestyle changes and medications exactly. It's also important to work actively with your doctor in your medical treatment. That means:

• Ask your doctor for details about your condition and understand it well.
• If there is anything you don't understand, ask questions. Don't be afraid, the doctor is there to help you.
• Find out what you can do to stop the disease from getting worse.
• Learn what the symptoms are and what to do if they occur.
• Be aware of treatment options.
• Ask your doctor about resources and support groups that can help you. These will help you meet other people who are in the same situation as you and share your experiences.

When should I see a doctor?

Get medical check-ups at least once a year. Be sure to go to the follow-up appointments your doctor has given you. Your doctor will tell you how often to come and what tests you need to have.

Also, if you develop any new symptoms or if your existing symptoms change, call your doctor immediately.

Remember as a summary

Aortoiliac Occlusive Disease is a type of peripheral artery disease. It can affect your quality of life and can lead to serious complications. But the good news is that you can do something every day to reduce your risk and control the progression of the disease. Talk to your doctor about how to manage your condition and what to expect in the future. You are not alone, and don't be afraid to ask for help.

` Aortoiliac Occlusive Disease, Peripheral Artery Disease, PAD, Blood Vessel Blockage, Leg Pain, Atherosclerosis, Plaque, Embolus, Intermittent Claudication, Stent, Bypass surgery