Gradual occlusion of the bifurcation of the abdominal aorta, produced by atherosclerosis , results in the characteristics clinical symptoms of pain in the legs on walking and also impotency. Impotency is caused by lack of blood in the internal iliac arteries. Otherwise in healthy individuals, surgical treatment by thromboendarterectomy (removal of thrombus and atherosclerotic inner lining from an obstructed artery) or a bypass graft should be considered. Because the progress of disease is slow. some collateral circulation is established, but is physiologically inadequate. However, the collateral blood flow does prevent tissue death in the both lower limbs, although skin ulcers may occur.
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