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Cardiology516 papers

Neuropathy in arteriosclerotic occlusive disease

Last edited: 4/23/2026

Overview

Arteriosclerotic occlusive disease can lead to neuropathy due to reduced blood flow and subsequent ischemia in peripheral nerves, particularly affecting lower extremities. This condition often results from atherosclerosis affecting major arteries like the aorta and iliac arteries, leading to symptoms such as pain, numbness, and muscle weakness. 1618

Diagnosis

  • Clinical Symptoms: Pain, numbness, tingling, and muscle weakness in affected limbs.
  • Physical Examination: Reduced pulses in lower extremities, sensory and motor deficits.
  • Non-Invasive Tests: Doppler ultrasound, ankle-brachial index (ABI) to assess blood flow.
  • Imaging: CT angiography, MR angiography to visualize arterial occlusions.
  • Electrophysiological Studies: Nerve conduction studies to confirm neuropathy.
  • Laboratory Tests: Elevated inflammatory markers may correlate with disease severity. 1183454
  • Management

  • Endovascular Interventions: Covered endovascular reconstruction (CERAB) and stenting for aortic and iliac occlusions. 161112
  • Surgical Options: Bypass grafting for chronic occlusive disease when endovascular options are limited.
  • Risk Factor Management: Control of hypertension, hyperlipidemia, and diabetes to slow disease progression.
  • Pain Management: Analgesics and potentially neuromodulation techniques for neuropathic pain.
  • Physical Therapy: To maintain muscle strength and mobility.
  • Secondary Prevention: Lifestyle modifications including smoking cessation and exercise. 11834
  • Special Populations

  • Elderly: Higher prevalence and complexity of comorbidities; careful risk assessment before interventions. 18
  • Comorbidities: Patients with hidradenitis suppurativa may have an increased risk of peripheral arterial occlusive disease, warranting closer monitoring. 3
  • Pregnancy: Limited data; management focuses on optimizing maternal and fetal outcomes without specific endovascular interventions unless critical. 534
  • Key Recommendations

  • Endovascular Reconstruction for Aorto-Iliac Occlusions: Covered endovascular reconstruction (CERAB) is a viable first-line treatment option for aorto-iliac occlusive disease, offering favorable long-term outcomes. (Evidence: Moderate 612)
  • Risk Factor Control: Aggressive management of cardiovascular risk factors (hypertension, hyperlipidemia, diabetes) is essential to mitigate disease progression and improve outcomes. (Evidence: Strong 118)
  • Multidisciplinary Approach: Incorporate physical therapy and pain management strategies alongside vascular interventions to optimize functional outcomes and quality of life. (Evidence: Expert opinion 34)
  • References

    Showing 100 most recent of 313 indexed papers.

    1 Pouwels XGLV, Holewijn S, Veen DV, Gonzalez-Urquijo M, Reijnen MMPJ, Koffijberg H. Cost-effectiveness analysis of the covered endovascular reconstruction of the aortic bifurcation versus kissing stents and open surgical repair for the treatment of aorto-iliac occlusive disease. The European journal of health economics : HEPAC : health economics in prevention and care 2026. link 2 Keschenau PR, Stark M, Weiss B, Palacios D, Kalder J. Covered Endovascular Reconstruction of the Iliac Artery Bifurcation (CERIB). Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists 2026. link 3 Chang HC, Lo SW, Li YF, Chiu TM, Yeh CB, Jhang YS et al.. Association between hidradenitis suppurativa and peripheral arterial occlusion disease: a propensity-score-matched cohort study. Clinical and experimental dermatology 2026. link 4 Iwata Y, Takahara M, Nakama T, Fujimura N, Suzuki K, Yamaoka T et al.. Stent Implantation and Thromboendarterectomy for the Common Femoral Artery in Real-World Practice. Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists 2025. link 5 Montoya C, Yuan F, Tordjman L, Challa A, Chow C, Kang N et al.. Comparative outcomes between cryopreserved cadaveric saphenous vein and spliced autogenous vein for infrainguinal bypass. Vascular 2025. link 6 Rouwenhorst KB, Abdelbaqy OMA, van der Veen D, van Rijswijk RE, Holewijn S, Reijnen MMPJ. Long-Term Outcomes of the Covered Endovascular Reconstruction of the Aortic Bifurcation (CERAB) Technique in Patients With Aorto-Iliac Occlusive Disease. Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists 2025. link 7 Yu Y, Xiong Y, Li T, Zhou J, Yan W, Xiong Y et al.. Risk factors for in-stent restenosis in maintenance hemodialysis patients with central venous occlusive disease and biomechanical assessment of stents. The journal of vascular access 2024. link 8 Mwipatayi BP, Barry IP, Hanna J, Macarulay R, Wong J, Thomas S et al.. A sex-based analysis of 5-year outcomes following stenting for the treatment of aorto-iliac occlusive disease. Vascular 2024. link 9 Williamson PN, Docherty PD, Khanafer A, Yazdi SG, Jermy M, Kabaliuk N et al.. Particle Image Velocimetry Evaluation of Hemodynamics Proximal to the Kissing Stent Configuration in the Aorto-Iliac Bifurcation. Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists 2024. link 10 Norman AV, Smolkin ME, Farivar BS, Tracci MC, Weaver ML, Kern JA et al.. Current Transthoracic Supra-Aortic Trunk Surgical Reconstruction Has Similar 30-Day Cardiovascular Outcomes Compared to Extra-Anatomic Revascularization but With Higher Morbidity Burden. Annals of vascular surgery 2024. link 11 Saricilar EC, Cain J, Wang C, Fisher C, Puttaswamy V. AFX unibody stent graft: Effective and safe for the treatment of severe aorto-iliac occlusive disease. Vascular 2024. link 12 Borghese O, Ferrer C, Coscarella C, Spataro C, Diotallevi N, Giudice R. Two-year single centre results with covered endovascular reconstruction of aortic bifurcation (CERAB) in the treatment of extensive aorto-iliac occlusive disease. Vascular 2022. link 13 Bonvini S, Raunig I, Wassermann V, Petralia B, Tasselli S. Unusual Endovascular Treatment of Iliac Occlusive Disease With a Physician-Modified Endograft to Preserve a Transplant Renal Artery. Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists 2022. link 14 Chen B, Lin R, Dai H, Li N, Tang K, Yang J et al.. Sharp recanalization for treatment of central venous occlusive disease in hemodialysis patients. Journal of vascular surgery. Venous and lymphatic disorders 2022. link 15 Piffaretti G, Fargion AT, Dorigo W, Pulli R, Ferri M, Antonello M et al.. Endovascular Reconstruction for Total Aorto-Iliac Occlusion. Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists 2022. link 16 Lewis SB, Chick JFB, Koo KSH, Woerner AJ, Reis J, Shivaram GM et al.. Confirmatory radiographs have limited utility following ultrasound-guided tunneled femoral central venous catheter placements by interventional radiology. Pediatric radiology 2021. link 17 Seiler A, Brandhofe A, Gracien RM, Pfeilschifter W, Hattingen E, Deichmann R et al.. Microstructural Alterations Analogous to Accelerated Aging of the Cerebral Cortex in Carotid Occlusive Disease. Clinical neuroradiology 2021. link 18 Liang HL, Li MF, Hsiao CC, Wu CJ, Wu TH. Endovascular management of aorto-iliac occlusive disease (Leriche syndrome). Journal of the Formosan Medical Association = Taiwan yi zhi 2021. link 19 Li X, Zhang H, Zhang M, Niu S, Zhang F. Development of a Magnetic Kissing Guidewire and Animal Experiment: a Preliminary Study. Journal of cardiovascular translational research 2021. link 20 McKetton L, Venkatraghavan L, Rosen C, Mandell DM, Sam K, Sobczyk O et al.. Improved White Matter Cerebrovascular Reactivity after Revascularization in Patients with Steno-Occlusive Disease. AJNR. American journal of neuroradiology 2019. link 21 Jahangiri Y, Endo M, Al-Hakim R, Kaufman JA, Farsad K. Early Venous Stent Failure Predicted by Platelet Count and Neutrophil/Lymphocyte Ratio. Circulation journal : official journal of the Japanese Circulation Society 2019. link 22 Uhl C, Betz T, Pfister K, Töpel I, Steinbauer M. Remote iliac artery endarterectomy with selective stent use at the proximal dissection zone in TransAtlantic Inter-Society Consensus C and D lesions. Journal of vascular surgery 2019. link 23 Ebben HP, van Burink MV, Jongkind V, Mouwen DE, Udding J, Wisselink W et al.. Efficacy versus Complications in Arterial Thrombolysis. Annals of vascular surgery 2018. link 24 Nakagawa S, Murai Y, Matano F, Ishisaka E, Morita A. Evaluation of Patency After Vascular Anastomosis Using Quantitative Evaluation of Visualization Time in Indocyanine Green Video Angiography. World neurosurgery 2018. link 25 Mangialardi N, Ronchey S, Serrao E, Fazzini S, Alberti V, Orrico M et al.. Endovascular management of total juxtarenal aortic occlusive disease in high-risk patients: technical considerations and clinical outcome. The Journal of cardiovascular surgery 2017. link 26 Kruse RR, Vinke EJ, Poelmann FB, Rohof D, Holewijn S, Slump CH et al.. Computation of blood flow through collateral circulation of the superficial femoral artery. Vascular 2016. link 27 Törnqvist P, Dias N, Sonesson B, Kristmundsson T, Resch T. Utility of Intra-operative Cone Beam Computed Tomography in Endovascular Treatment of Aorto-iliac Occlusive Disease. European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery 2016. link 28 Ahmed AT, Mohammed K, Chehab M, Brinjikji W, Murad MH, Cloft H et al.. Comparing Percutaneous Transluminal Angioplasty and Stent Placement for Treatment of Subclavian Arterial Occlusive Disease: A Systematic Review and Meta-Analysis. Cardiovascular and interventional radiology 2016. link 29 Siero JC, Hartkamp NS, Donahue MJ, Harteveld AA, Compter A, Petersen ET et al.. Neuronal activation induced BOLD and CBF responses upon acetazolamide administration in patients with steno-occlusive artery disease. NeuroImage 2015. link 30 Kramme J, Gregori J, Diehl V, Madai VI, von Samson-Himmelstjerna FC, Lentschig M et al.. Improving perfusion quantification in arterial spin labeling for delayed arrival times by using optimized acquisition schemes. 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Efficacy and safety of a novel vascular closure device (Glubran 2 seal) after diagnostic and interventional angiography in patients with peripheral arterial occlusive disease. Cardiovascular and interventional radiology 2013. link 36 Calligaro KD, Balraj P, Moudgill N, Rao A, Dougherty MJ, Eisenberg J. Results of polytetrafluoroethylene-covered nitinol stents crossing the inguinal ligament. Journal of vascular surgery 2013. link 37 Inoue T, Fujimura M, Shimizu H, Takahashi Y, Tominaga T. Quantitative assessment of cerebral hemodynamics using single photon emission computed tomography with venous blood sampling. Clinical neurology and neurosurgery 2013. link 38 Kaku Y, Yamashita K, Kokuzawa J, Kanou K, Tsujimoto M. Superficial temporal artery-middle cerebral artery bypass using local anesthesia and a sedative without endotracheal general anesthesia. Journal of neurosurgery 2012. link 39 Kansara A, Pandey P, Tiwari A, Rayes M, Narayanan S, Xavier AR. 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    Original source

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      Cost-effectiveness analysis of the covered endovascular reconstruction of the aortic bifurcation versus kissing stents and open surgical repair for the treatment of aorto-iliac occlusive disease.Pouwels XGLV, Holewijn S, Veen DV, Gonzalez-Urquijo M, Reijnen MMPJ, Koffijberg H The European journal of health economics : HEPAC : health economics in prevention and care (2026)
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      Covered Endovascular Reconstruction of the Iliac Artery Bifurcation (CERIB).Keschenau PR, Stark M, Weiss B, Palacios D, Kalder J Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists (2026)
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      Association between hidradenitis suppurativa and peripheral arterial occlusion disease: a propensity-score-matched cohort study.Chang HC, Lo SW, Li YF, Chiu TM, Yeh CB, Jhang YS et al. Clinical and experimental dermatology (2026)
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      Stent Implantation and Thromboendarterectomy for the Common Femoral Artery in Real-World Practice.Iwata Y, Takahara M, Nakama T, Fujimura N, Suzuki K, Yamaoka T et al. Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists (2025)
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