Skip to main content

Abdominal Aortic Occlusive Disease

  • Chapter
  • First Online:
Book cover Diseases of the Aorta
  • 1048 Accesses

Abstract

Aortoiliac occlusive disease manifests with a broad spectrum clinically, from asymptomatic disease to critical limb ischemia. Vascular laboratory and axial imaging studies are essential to confirm the lesion and develop an intervention plan. Medical treatment should be initiated early, although it plays a limited role. With recent advances in percutaneous endovascular devices, a variety of minimally invasive solutions exist with favorable long-term patency and durability. Open surgical endarterectomy and bypass still remain a durable option for patients with advanced disease or failed endovascular therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Leriche R, Morel A. The syndrome of thrombotic obliteration of the aortic bifurcation. Ann Surg. 1948;127(2):193–206.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Wylie E. Thromboendarterectomy for arteriosclerotic thrombosis of major arteries. Surgery. 1952;32:275–92.

    CAS  PubMed  Google Scholar 

  3. Selvin E, Erlinger T. Prevalence of and risk factors for peripheral arterial disease in the United States: results from the National Health and Nutrition Examination Survey. Circulation. 2004;110:738–43.

    Article  PubMed  Google Scholar 

  4. Murabito J, D’Agostino R, Silbershatz H, Wilson W. A risk profile from the Framingham Heart Study. Circulation. 1997;96:44–9.

    Article  CAS  PubMed  Google Scholar 

  5. Malone J, Moore W, Goldstone J. Aortoiliac reconstruction. Surgery. 1977;81:551.

    CAS  PubMed  Google Scholar 

  6. Cronenwett J, Davis J, Gooch J, Garrett H. Aortoiliac occlusive disease in women. Surgery. 1980;88:775–84.

    CAS  PubMed  Google Scholar 

  7. Starrett R, Stoney R. Juxta-renal aortic occlusion. Surgery. 1974;76:890.

    CAS  PubMed  Google Scholar 

  8. Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FGR. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). J Vasc Surg. 2007;45(Suppl S):S5–67. https://doi.org/10.1016/j.jvs.2006.12.037.

    Article  PubMed  Google Scholar 

  9. Romano M, Mainenti P, Imbriaco M, et al. Multidetector row CT angiography of the abdominal aorta and lower extremities in patients with peripheral artery occlusive disease: diagnostic accuracy and interobserver agreement. Eur J Radiol. 2004;50(3):303–8.

    Article  PubMed  Google Scholar 

  10. Menke J, Larsen J. Meta-analysis: accuracy of contrast-enhanced magnetic resonance angiography for assessing steno-occlusions in peripheral arterial disease. Ann Intern Med. 2010;153(5):325.

    Article  PubMed  Google Scholar 

  11. Willigendael EM, Teijink JAW, Bartelink M, Peters RJG, Buller HR, Prins MH. Smoking and the patency of lower extremity bypass grafts: a meta-analysis. J Vasc Surg. 2005;42:67–74. https://doi.org/10.1016/j.jvs.2005.03.024.

    Article  PubMed  Google Scholar 

  12. Lassila R, Lepäntalo M. Cigarette smoking and the outcome after lower limb arterial surgery. Acta Chir Scand. 1988;154(11–12):635–40.

    CAS  PubMed  Google Scholar 

  13. Sacks FM, Pfeffer MA, Moye LA, et al. The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. Cholesterol and Recurrent Events Trial investigators. N Engl J Med. 1996;335:1001–9.

    Article  CAS  PubMed  Google Scholar 

  14. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet. 1994;344:1383–9.

    Google Scholar 

  15. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. The Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group. N Engl J Med. 1998;339:1349–57.

    Google Scholar 

  16. Hirsch AT, Haskal ZJ, Hertzer NR, et al. ACC/AHA practice guidelines ACC/AHA 2005 practice guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic). Circulation. 2006;113:e463–654. https://doi.org/10.1161/CIRCULATIONAHA.106.174526.

    Article  PubMed  Google Scholar 

  17. Psaty B, Smith N, Siscovick D, et al. Health outcomes associated with antihypertensive therapies used as first-line agents. A systematic review and meta-analysis. JAMA. 1997;277(9):739–45.

    Article  CAS  PubMed  Google Scholar 

  18. Conte MS, Pomposelli FB, Clair DG, et al. Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: management of asymptomatic disease and claudication. J Vasc Surg. 2015;61(3):2S–41S. https://doi.org/10.1016/j.jvs.2014.12.009.

    Article  PubMed  Google Scholar 

  19. Berger PB, Bhatt DL, Fuster V, et al. Bleeding complications with dual antiplatelet therapy among patients with stable vascular disease or risk factors for vascular disease. Circulation. 2010;121:2575–83. https://doi.org/10.1161/CIRCULATIONAHA.109.895342.

    Article  CAS  PubMed  Google Scholar 

  20. Watson L, Ellis B, Leng G. Exercise for intermittent claudication. Cochrane Database Syst Rev. 2008;4:CD000990.

    Google Scholar 

  21. Porter J, Cutler B, Lee B, et al. Pentoxifylline efficacy in the treatment of intermittent claudication: multicenter controlled double-blind trial with objective assessment of chronic occlusive arterial disease patients. Am Heart J. 1982;104(1):66–72.

    Article  CAS  PubMed  Google Scholar 

  22. Robless P, Mikhailidis D, Stansby G. Cilostazol for peripheral arterial disease. Cochrane Database Syst Rev. 2008;1:CD003748.

    Google Scholar 

  23. Dawson DL, Cutler BS, Hiatt WR, et al. A comparison of cilostazol and pentoxifylline for treating intermittent claudication. Am J Med. 2000;109:523–30.

    Article  CAS  PubMed  Google Scholar 

  24. Kannel WB, Skinner JJ, Schwartz MJ, Shurtleff D. Intermittent claudication incidence in the Framingham Study. Circulation. 1970;41(5):875–83.

    Article  CAS  PubMed  Google Scholar 

  25. Jaff MR, White CJ, Hiatt WR, et al. An update on methods for revascularization and expansion of the TASC lesion classification to include below-the-knee arteries: a supplement to the Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). J Endovasc Ther. 2015;22(5):663–77. https://doi.org/10.1177/1526602815592206.

    Article  PubMed  Google Scholar 

  26. Sharafuddin MJ, Hoballah JJ, Kresowik TF, Sharp WJ. Kissing stent reconstruction of the aortoiliac bifurcation. Perspect Vasc Surg Endovasc Ther. 2008;20(1):50–60.

    Article  PubMed  Google Scholar 

  27. Yilmaz S, Sindel T, Golbasi I, Turkay C, Mete A, Luleci E. Aortoiliac kissing stents: long-term results and analysis of risk factors affecting patency. J Endovasc Ther. 2006;13:291–301.

    Article  PubMed  Google Scholar 

  28. Rzucidlo EM, Powell RJ, Zwolak RM, et al. Early results of stent-grafting to treat diffuse aortoiliac occlusive disease. J Vasc Surg. 2003;37:1175–80. https://doi.org/10.1016/S0741-5214(03)00326-4.

    Article  PubMed  Google Scholar 

  29. Aburahma AF, Hayes JD, Flaherty SK, Peery W. Primary iliac stenting versus transluminal angioplasty with selective stenting. J Vasc Surg. 2007;46:965–70. https://doi.org/10.1016/j.jvs.2007.07.027.

    Article  PubMed  Google Scholar 

  30. Reekers J, Vorwerk D, Rousseau H, et al. Results of a European multicentre iliac stent trial with a flexible balloon expandable stent. Eur J Vasc Endovasc Surg. 2002;24:511–5. https://doi.org/10.1053/ejvs.2002.1775.

    Article  CAS  PubMed  Google Scholar 

  31. Tetteroo E, Van Der Graaf Y, Bosch JL, et al. Randomised comparison of primary stent placement versus primary angioplasty followed by selective stent placement in patients with iliac-artery occlusive disease. Lancet. 1998;351:1153–9.

    Article  CAS  PubMed  Google Scholar 

  32. Chang RW, Goodney PP, Baek JH, Nolan BW, Rzucidlo EM, Powell RJ. Long-term results of combined common femoral endarterectomy and iliac stenting / stent grafting for occlusive disease. J Vasc Surg. 2008;48:362–7. https://doi.org/10.1016/j.jvs.2008.03.042.

    Article  PubMed  Google Scholar 

  33. Dake MD, Ansel GM, Jaff MR, et al. Paclitaxel-eluting stents show superiority to balloon angioplasty and bare metal stents in twelve-month Zilver PTX randomized study results. Circ Cardiovasc Interv. 2011;4:495–504. https://doi.org/10.1161/CIRCINTERVENTIONS.111.962324.

    Article  CAS  PubMed  Google Scholar 

  34. Jongsma H, Bekken J, de Vries J-P, Verhagen H, Fioole B. Drug-eluting balloon angioplasty versus uncoated balloon angioplasty in patients with femoropopliteal arterial occlusive disease. J Vasc Surg. 2016;64:1503–14.

    Article  PubMed  Google Scholar 

  35. Siablis D, Karnabatidis D, Katsanos K, et al. Infrapopliteal application of sirolimus-eluting versus bare metal stents for critical limb ischemia: analysis of long-term angiographic and clinical outcome. J Vasc Interv Radiol. 2009;20(9):1141–50.

    Article  PubMed  Google Scholar 

  36. Levine GN, Bates ER, Blankenship JC, et al. 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention. Circulation. 2011;124:e574–651. https://doi.org/10.1161/CIR.0b013e31823ba622.

    Article  PubMed  Google Scholar 

  37. Ichihashi S, Higashiura W, Itoh H, Sakaguchi S, Nishimine K, Kichikawa K. Long-term outcomes for systematic primary stent placement in complex iliac artery occlusive disease classified according to Trans-Atlantic Inter-Society Consensus (TASC)-II. J Vasc Surg. 2011;53(4):992–9. https://doi.org/10.1016/j.jvs.2010.10.069.

    Article  PubMed  Google Scholar 

  38. Freeman NE, Leeds FH. Operations on large arteries application of recent advances. Calif Med. 1952;77(4):229–33.

    CAS  PubMed  PubMed Central  Google Scholar 

  39. Louw J. Splenic-to-femoral and axillary-to-femoral bypass grafts in diffuse atherosclerotic occlusive disease. Lancet. 1963;281:1401–2.

    Article  Google Scholar 

  40. Blaisdell F, Hall A. Axillary-femoral artery bypass for lower extremity ischemia. Surgery. 1963;54:563–8.

    CAS  PubMed  Google Scholar 

  41. Taylor LM, Park TC, Edwards JM, et al. Acute disruption of polytetrafluoroethylene grafts adjacent to axillary anastomoses: a complication of axillofemoral grafting. J Vasc Surg. 1994;20:520–8.

    Article  PubMed  Google Scholar 

  42. Jacobs DL, et al. True lumen reentry devices facilitate subintimal angioplasty and stenting of total chronic occlusions: Initial report. J Vasc Surg. 2006;43:1291–6.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Lim, S., Crisostomo, P.R. (2019). Abdominal Aortic Occlusive Disease. In: Dieter, R., Dieter Jr., R., Dieter III, R. (eds) Diseases of the Aorta . Springer, Cham. https://doi.org/10.1007/978-3-030-11322-3_15

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-11322-3_15

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-11321-6

  • Online ISBN: 978-3-030-11322-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics