Lower extremity blockages in the arteries can cause several symptoms. One is pain in the muscles at a distance when walking. That distance can be relatively short, or the distance can be long, but it causes almost a charley horse kind of ache in the muscles of the calf, the thigh, or the buttock. The blockages in the arteries to the lower extremity can occur at many levels. One level is within the aorta in the abdomen, and in whatÕs called the iliac arteries in the pelvis as they come out to become the femoral arteries in the groin. ThatÕs called aortoiliac disease. When that becomes severe enough, patients may develop whatÕs called claudication of the thigh and buttock. When we treat that, we have to evaluate the anatomy of the aortoiliac segment, the aorta and iliac arteries in the pelvis, usually with CT scan and what we call CTA, or CT angiography when contrast is given so we can look specifically at the anatomy of those arteries. ThereÕs open surgery. ThereÕs less invasive angioplasty and stenting. And thereÕs what we call hybrid procedures where an element of an open operation is performed in conjunction with wires, catheters, angioplasty, other technology to reduce the amount of narrowing in the arteries to the legs. Patients with aortoiliac occlusive disease, or with blockages in their legs, should come to the University of Virginia Medical Center. We have many specialists who provide care in a comprehensive, multidisciplinary manner. We have full capability to perform any kind of bypass surgery that might be necessary, given the patientÕs anatomy. We also have a multitude of specialists with unique skill in treating artery blockages in the lower extremities with less invasive options.