Ultrasound Scan:
Aortoiliac Arteries

Aortoiliac artery disease, also known as aortoiliac occlusive disease or aortoiliac arteriosclerosis, refers to a condition characterised by the narrowing or blockage of the aortoiliac arteries. These arteries are major blood vessels that supply oxygenated blood to the lower abdomen, pelvis, and legs. The most common cause of aortoiliac artery disease is atherosclerosis, which is the buildup of plaque consisting of cholesterol, fatty deposits, and other substances on the inner walls of the arteries. Over time, this plaque can harden and narrow the arterial lumen, restricting blood flow to the affected regions. Prior to the artery completely blocking, the narrowing (or stenosis) progresses over time and amplifies your symptoms. The symptoms of a narrowing tends to start with pain in the legs when walking short distances. This can progress to rest pain which occurs when the blood flow trying to move towards your feet is insufficient while you are laying flat; but on sitting up gravity can assist the blood to the foot providing relief.

We request a 4 hr fast for this ultrasound study.

Eating creates a gas that ultrasound is unable to scan through and may obstruct structures and vessels we need to see.

An aortoiliac ultrasound scan usually takes between 20-30 minutes.

The purpose of this ultrasound scan is to assess the blood flow through the arteries in your abdomen. This ultrasound requires direct contact with your skin. The scan will assess the arteries from as high as the diaphragm to the level of the hips. We will require you to lift your jumper and shirt up and also shuffle your trousers down to the hips.

We will ask for you to lie on your back on our examination bed. During the scan we will apply ultrasound gel to your abdomen and use the ultrasound machine to look at the the arteries to assess for narrowing and blockages. You will hear noises from the ultrasound machine; this is all normal and is the sound of the blood flow moving through your arteries.

An aortoiliac artery ultrasound, also known as aortoiliac duplex ultrasound, is performed to evaluate the anatomy and blood flow in the aorta and iliac arteries. It is a non-invasive imaging test that uses ultrasound waves to create real-time images and assess blood flow characteristics. Aortoiliac Doppler ultrasound scans are used to evaluate the blood flow through the aorta and iliac arteries. It is a non-invasive imaging technique that can detect plaque build-up, blockages, narrowings (stenosis) and occlusions which may be affecting the amount of blood flow reaching your feet. Aortoiliac ultrasound scans provide a detailed worksheet and report for your treating doctor to use to identify any issues, surveillance known disease or plan for surgery. Here are some common reasons why an aortoiliac artery ultrasound may be done:

Peripheral arterial disease (PAD)

Aortoiliac artery ultrasound is commonly used to diagnose and evaluate the severity of peripheral arterial disease. It can assess the presence of atherosclerosis (plaques) in the aorta and iliac arteries, which can cause narrowing or blockage, reducing blood flow to the lower extremities.

Claudication

Claudication refers to leg pain or cramping that occurs during physical activity and is relieved by rest. Aortoiliac artery ultrasound can help identify the presence and location of any significant arterial blockages that may be causing claudication symptoms.

Evaluation of aneurysms

Aneurysms are abnormal bulges or dilations of the blood vessels that can occur in the aorta or iliac arteries. Aortoiliac artery ultrasound can assess the size, location, and characteristics of an aneurysm, providing important information for monitoring and management.

Follow-up after intervention or surgery

If a person has undergone previous intervention or surgery, such as angioplasty or stent placement, to treat aortoiliac artery disease, follow-up ultrasound examinations may be performed to assess the effectiveness of the procedure and monitor the condition over time.

Screening for aortoiliac disease

Aortoiliac artery ultrasound may be used as a screening tool in individuals at high risk for developing aortoiliac artery disease, such as those with a history of smoking, diabetes, hypertension, or other cardiovascular risk factors.

The results of an aortoiliac artery ultrasound can provide valuable information about the presence and severity of arterial disease, assist in treatment planning, and guide further diagnostic or therapeutic interventions if necessary.

Aortoiliac artery disease, also known as aortoiliac occlusive disease or aortoiliac artery stenosis, involves the narrowing or blockage of the aorta or iliac arteries, which are major blood vessels supplying the lower abdomen, pelvis, and lower extremities. Several risk factors are associated with the development of aortoiliac artery disease. These risk factors include:

Age

Aortoiliac artery disease becomes more prevalent with advancing age. The risk increases significantly in individuals over the age of 60.

Smoking

Smoking is a major modifiable risk factor for aortoiliac artery disease. The toxins in tobacco smoke can damage the arterial walls and accelerate the progression of atherosclerosis, a condition characterised by the buildup of plaque in the arteries.

Diabetes

Individuals with diabetes have an increased risk of developing aortoiliac artery disease. Diabetes can lead to metabolic abnormalities and promote the development of atherosclerosis.

Hypertension

High blood pressure can contribute to the development and progression of aortoiliac artery disease. Elevated blood pressure places increased stress on the arterial walls, potentially leading to damage and atherosclerosis.

Hyperlipidemia

Elevated levels of cholesterol and triglycerides in the blood, often associated with hyperlipidemia, are known risk factors for aortoiliac artery disease. High levels of LDL cholesterol ("bad" cholesterol) can contribute to the formation of arterial plaques.

Obesity

Excess body weight, particularly abdominal obesity, increases the risk of aortoiliac artery disease. Obesity is associated with a higher likelihood of developing atherosclerosis and related cardiovascular conditions.

Family history

Having a family history of aortoiliac artery disease or other vascular conditions increases the risk of developing the disease. Genetic factors can influence an individual's susceptibility to atherosclerosis and arterial blockages.

Sedentary lifestyle

Lack of physical activity and a sedentary lifestyle contribute to several cardiovascular risk factors, including obesity, hypertension, and dyslipidemia, all of which can increase the risk of aortoiliac artery disease.

Other medical conditions

Certain medical conditions, such as chronic kidney disease, peripheral artery disease (PAD), and coronary artery disease (CAD), are associated with a higher risk of developing aortoiliac artery disease.

Aortoiliac artery disease, also known as aortoiliac occlusive disease or aortoiliac artery stenosis, refers to the narrowing or blockage of the aorta or iliac arteries, which are major blood vessels supplying the lower abdomen, pelvis, and lower extremities. The symptoms of aortoiliac artery disease can vary depending on the extent and severity of the arterial blockage. Common symptoms may include:

​

Claudication

Claudication refers to muscle pain, cramping, or weakness in the legs that typically occurs during physical activity, such as walking or exercising. It is usually relieved with rest. Claudication in aortoiliac artery disease commonly affects the buttocks, thighs, or calves.

Leg pain or discomfort at rest

As the disease progresses and arterial blockage becomes more severe, individuals may experience leg pain or discomfort even while at rest. This is known as rest pain and is typically more severe than claudication pain.

Cold or numb extremities

Reduced blood flow to the lower extremities due to aortoiliac artery disease can cause the legs or feet to feel cold or numb. The affected area may also appear pale or have a bluish tinge.

Weak or absent pulses

Healthcare providers may detect weak or absent pulses in the femoral arteries, which are located in the groin area, during a physical examination.

Erectile dysfunction (in males)

Aortoiliac artery disease can impair blood flow to the pelvic region, leading to difficulties achieving or maintaining an erection.

Non-healing wounds or ulcers

Severe cases of aortoiliac artery disease can result in reduced blood flow to the lower extremities, causing wounds or ulcers on the legs or feet that are slow to heal.

The treatment options for aortoiliac artery disease, also known as aortoiliac occlusive disease or aortoiliac artery stenosis, depend on the severity of symptoms, the extent of arterial blockage, and individual patient factors. The primary goals of treatment are to relieve symptoms, improve blood flow, and reduce the risk of complications. Here are some common treatment options for aortoiliac artery disease:

Lifestyle modifications: Making certain lifestyle changes can help manage aortoiliac artery disease and reduce the progression of atherosclerosis. These may include smoking cessation, adopting a healthy diet low in saturated fats and cholesterol, engaging in regular exercise, and maintaining a healthy weight.

Medications: Medications may be prescribed to manage risk factors associated with aortoiliac artery disease. These can include:

• Antiplatelet agents: Medications such as aspirin or clopidogrel may be prescribed to reduce the risk of blood clot formation and improve blood flow.

• Cholesterol-lowering medications: Statins or other lipid-lowering medications may be prescribed to manage high cholesterol levels and slow down the progression of atherosclerosis.

• Blood pressure control: Medications to control hypertension may be prescribed to reduce blood pressure and minimize the risk of further arterial damage.

Endovascular procedures:

• Angioplasty and stenting: This minimally invasive procedure involves the insertion of a balloon-tipped catheter into the narrowed or blocked artery. The balloon is inflated to widen the artery, and a stent (a small mesh tube) may be placed to keep the artery open and improve blood flow.

Bypass surgery: In severe cases of aortoiliac artery disease or when endovascular procedures are not suitable or effective, bypass surgery may be considered. This involves creating a detour around the blocked or narrowed artery using a graft (artificial or natural blood vessel) to restore blood flow to the lower extremities.

Thrombolytic therapy: In cases where there is a blood clot (thrombus) causing significant arterial blockage, thrombolytic therapy may be used. Medications are administered intravenously to dissolve the clot and restore blood flow.

The choice of treatment depends on several factors, including the severity of the disease, the presence of symptoms, the extent of arterial blockage, and individual patient characteristics.