Patient presents with symptoms suggestive of iliac artery stenosis, including intermittent claudication, buttock pain, thigh pain, and lower extremity weakness during exertion.  These symptoms are consistent with reduced blood flow to the lower limbs.  Physical examination revealed diminished femoral pulses and a cool extremity, indicating peripheral artery disease.  Diagnostic testing, including ankle-brachial index (ABI) measurement and duplex ultrasound of the iliac arteries, confirmed the diagnosis of iliac artery stenosis.  The ABI was significantly reduced, below the diagnostic threshold.  Duplex ultrasound imaging demonstrated a focal stenosis in the right external iliac artery with elevated peak systolic velocities, consistent with significant narrowing.  Risk factors for atherosclerosis, including hyperlipidemia, hypertension, and a history of smoking, were noted.  The patient's current medications include a statin for cholesterol management and an antihypertensive.  Treatment options, including lifestyle modifications, supervised exercise therapy, and potential endovascular intervention such as angioplasty or stenting, were discussed with the patient.  A follow-up appointment was scheduled to assess symptom progression and discuss further management strategies, considering the severity of the stenosis and the patient's overall clinical picture.  Referral to a vascular specialist is being considered for further evaluation and possible intervention.  Medical coding will reflect the specific location and severity of the iliac artery stenosis, along with associated comorbidities and procedures performed.