Arteriosclerosis obliterans:

Arteriosclerosis obliterans: 

Arteriosclerosis obliterans, also known as peripheral arterial disease (PAD), is a condition where there is a narrowing or blockage of arteries that supply blood to the limbs, typically the legs. This narrowing is caused by a buildup of plaque inside the arteries, which restricts blood flow to the muscles and other tissues in the legs. As a result, people with this condition may experience pain and weakness in their legs when walking or exercising. Arteriosclerosis obliterans is a progressive disease that can lead to serious complications such as infections, gangrene, and even amputation of the affected limb.


The exact cause of arteriosclerosis obliterans is not fully understood, but it is believed to be caused by a combination of genetic and lifestyle factors. Some common causes and risk factors include:

  • Smoking: Smoking is a major risk factor for arteriosclerosis obliterans as it damages the walls of the arteries and contributes to the buildup of plaque.
  • High blood pressure: People with high blood pressure are at a greater risk of developing arteriosclerosis obliterans as it can damage the arteries over time.
  • Diabetes: Diabetes can cause damage to the arteries and increase the risk of developing arteriosclerosis obliterans.
  • High cholesterol: High levels of cholesterol in the blood can contribute to the buildup of plaque in the arteries.
  • Age: Arteriosclerosis obliterans is more common in people over the age of 50.
  • Family history: People with a family history of arteriosclerosis obliterans are more likely to develop the condition.


The symptoms of arteriosclerosis obliterans can vary depending on the severity of the condition. Some common symptoms include:

  • Pain or cramping in the legs, particularly when walking or exercising.
  • Numbness or weakness in the legs.
  • Coldness in the feet or legs.
  • Sores or wounds on the feet or legs that heal slowly.
  • Weak or absent pulses in the legs.
  • Erectile dysfunction in men.


Diagnosing arteriosclerosis obliterans typically involves a physical exam and imaging tests to evaluate blood flow in the affected limb. The tests may include:

  • Ankle-brachial index (ABI): This test measures the blood pressure in the arms and legs to determine if there is reduced blood flow in the affected limb.
  • Doppler ultrasound: This test uses sound waves to create images of blood flow in the affected limb.
  • Magnetic resonance angiography (MRA): This imaging test uses a magnetic field and radio waves to create detailed images of the blood vessels in the affected limb.
  • Computed tomography angiography (CTA): This imaging test uses X-rays to create detailed images of the blood vessels in the affected limb.
  • Angiography: This test involves injecting a contrast dye into the blood vessels and taking X-rays to create detailed images of the blood vessels in the affected limb.

Note 1: The ankle/brachial index is the ratio of the systolic blood pressure at the ankle (determined by Doppler study) divided by the simultaneous brachial artery systolic blood pressure. The normal index is 1.0 or greater.

Note 2: Evaluate residuals of aortic and large arterial bypass surgery or arterial graft as arteriosclerosis obliterans.


Note 3: These evaluations are for involvement of a single extremity. If more than one extremity is affected, evaluate each extremity separately and combine (under §4.25), using the bilateral factor (§4.26), if applicable.

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