A 56-year-old man presents with a three-month history of erectile dysfunction and bilateral buttock pain on exertion, but not at rest. His past medical history is significant for type 2 diabetes, dyslipidemia, and hypertension. Examination reveals bilaterally diminished femoral pulses. What is the most likely diagnosis?
A. Diabetic amyotrophy
B. Spinal stenosis
C. Leriche syndrome (aortoiliac occlusive disease)
D. Acute aortic thrombosis
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