Atherosclerotic Occlusive Disease of Abdominal Aorta 
Particularly common in presence of diabetes mellitus or cigarette smoking. Symptoms include intermittent claudication of the buttocks and thighs and impotence (Leriche syndrome); femoral and other distal pulses are absent. Diagnosis is established by noninvasive leg pressure measurements and Doppler velocity analysis, and confirmed by MRI, CT, or aortography. Catheter-based endovascular treatment or aortic-femoral bypass surgery is required for symptomatic treatment.
Takayasu's (“Pulseless”) Disease
Arteritis of aorta and major branches predominantly in young women. Anorexia, weight loss, fever, and night sweats occur. Localized symptoms relate to occlusion of aortic branches (cerebral ischemia, claudication, and loss of pulses in arms). ESR and C-reactive protein are increased; diagnosis confirmed by CT, MRI, or aortography. Glucocorticoid and immunosuppressive therapy may be beneficial.
For a more detailed discussion, see Creager MA, Loscalzo J: Diseases of the Aorta, Chap. 301, p. 1637, in HPIM-19. |
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