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Aortoiliac occlusive disease

Case contributed by Franco A. Scola
Diagnosis almost certain

Presentation

Acute onset of pain in both legs and pelvis.

Patient Data

Age: 70 years
Gender: Female

Extensive atherosclerosis of the aorta and iliac arteries is demonstrated. 

There is total occlusion of the infrarenal abdominal aorta starting 1.2 cm distally from the left renal artery and extending into the bilateral iliac arteries.  No collateral vessels appreciated.

The inferior mesentery artery shows no contrast flow - likely occluded.

Approximately 50% ostial stenosis of the celiac trunk is demonstrated with good opacification of its branches.

The proximal superior mesenteric and renal arteries show wall calcifications without significant stenosis.

There is no demonstrable aneurysm.

Case Discussion

Aorto-iliac occlusive disease refers to total occlusion of the abdominal aorta due to thrombosis distal to the renal arteries and is often associated with atherosclerosis. It may be acute or chronic.  This is presumed to be an acute case due to the acute onset of presentation and to the lack of collateral formation.  

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