Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “CLAUDICATION”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 703 records · Page 39Linked to original sources
PubMed2006

Persistent sciatic artery: an uncommon cause of intermittent claudication.

Persistent sciatic artery (PSA) is a rarely seen variation of the lower limb vessels. Anatomically the PSA is the continuation of internal iliac arteries. It follows the sciatic nerve from the sciatic foramen to the level of the knee. We report our experience with conservative therapy in a patient with complete occlusion of a PSA. A 54-year-old man with typical symptoms of intermittent claudication on the left limb was referred to our Department. After clinical examination Doppler and duplex sonography were performed. Angiography showed bilateral PSA. On the left side the PSA was occluded. The patient received 20 intravenous courses of prostaglandin E1 for 4 weeks, followed by oral anticoagulation with phenprocoumon for life (INR: 2.5-3.5). After 3 years therapy he does not show any typical symptoms of intermittent claudication or limb ischemia. This case shows that conservative therapy may be effective. However, it has to be emphasised that this approach requires frequent clinical and duplex sonography follow-up every 3 to 6 months with oral anticoagulation.

Alprostadil↗
PubMed2006

[A 26-year-old cyclist with intermittent claudication].

A 26-year-old male amateur cyclist, with no risk factors for vascular disease or previous trauma, presented with left-calf claudication. Physical and additional examination revealed an occlusion of the external iliac artery. During the operation, the cause was found to be an endofibrotic lesion of the external iliac artery, probably due to mechanical trauma as a result of the non-physiological aerodynamic position held on the bicycle during many hours of training. An endarterectomy was performed and the tendon of the psoas-minor muscle was cut because of its strong impression on the psoas-major muscle, which resulted in kinking of the external iliac artery. There followed two episodes of re-occlusion which were treated with a venous interposition graft and a dacron interposition graft, respectively. Thereafter the patient was able to train without pain. Intermittent claudication of the legs in young athletes should not be underestimated; occlusive vascular disease caused by arterial endofibrosis should be considered.

Adult↗
PubMed2006

A pilot study of ranolazine in patients with intermittent claudication.

AIM: This pilot study provides preliminary information regarding safety and changes in exercise performance during treatment with ranolazine extended-release in patients with reproducible claudication during exercise treadmill testing (ETT). METHODS: We enrolled 45 patients with documented peripheral arterial disease, reproducible claudication on ETT, and ankle-brachial indices <0.85 at rest that decreased by at least 0.15% or 20% immediately postexercise. Randomized patients received double-blind treatment with either ranolazine 1 000 mg b.i.d. (n=22) or placebo (n=23) for 4 weeks. RESULTS: Compared with baseline, peak walking time (PWT) increased (mean+/-SEM) by 53+/-34 s with ranolazine (P=0.13) and by 41+/-33 s with placebo (P=0.22). Pain-free walking time during ETT increased by 62+/-18 s with ranolazine (P=0.002) and 36+/-18 s with placebo (P=0.045). Supplemental analyses, excluding patients with baseline exercise duration (16 min and (12 min, showed additional improvement with ranolazine on PWT. CONCLUSIONS: Ranolazine was well tolerated and these data provide a rationale for proceeding with a definitive trial.

Acetanilides↗
PubMed1991

[Intermittent claudication].

The symptom of intermittent claudication indicates a generalised arteriosclerosis. The high mortality of these patients is due to myocardial infarction, cerebrovascular events and rupture of aortic aneurysms. Prognostic factors for the progression of peripheral occlusive arterial disease to rest pain and trophical lesions are persistent nicotine consumption, arterial occlusions on more than one extremity, brachiopedal pressure quotient less than 0.5 and diabetes mellitus. Therapy of choice in most cases is the walking exercise. When the claudication distance remains very short or decompensation of peripheral circulation is imminent, reopening procedures like percutaneous transluminal angioplasty should be performed. If they are successless a prostanoid therapy is able to relief the complaints.

Combined Modality Therapy↗
PubMed1991

Optimal hematocrit in patients with intermittent claudication. Exercise-induced muscle tissue oxygen pressure after stepwise hemodilution.

In patients with severe intermittent claudication and concomitant high hematocrit values a hypervolemic (stepwise infusion of 500 ml 10% hydroxyethylsolution: mean molecular weight 200.000/substitution degree 0.5) or isovolemic hemodilution (stepwise venesection and subsequent infusion of 10% hydroxyethylstarch solution 200/0.5) was performed intraindividually. Measurements of muscle tissue oxygen pressure (pO2) values using a standardized pedalergometric exercise test were performed. The optimal results of muscle tissue pO2 behaviour after pedalergometric exercise were found at average hematocrit values of 40%-41% when isovolemic hemodilution was applied. Hypervolemic hemodilution improves muscle tissue oxygen supply at rest, but shows a retarded reactive hyperoxia under exercise conditions. Thus it is likely that in patients with severe intermittent claudication an optimal tissue oxygen supply can be obtained in the case of isovolemic hemodilution at hematocrit values of about 40-41%.

Exercise Test↗
PubMed1991

[Effects of physical exercise and indobufen in patients with intermittent claudication. Results after a 2-year follow-up].

The study included 18 patients suffering from intermittent claudication before (stage 1) and after (stage 2) 3 months of rehabilitative training and after 2 years of follow-up (stage 3) during which patients undertook regular exercise (walking for 1 hour 3-4 days a week) and antiplatelet aggregating therapy with indobufen (200 mg x 2/day). A comparison of the data revealed that:a) there was a significant and gradual increase in the claudication pain distance (CPD) and maximal walking distance (MWD), and a reduced recovery time between stages 1 and 3 (parameters were assessed during and after walking on a treadmill (rolling mat) at a speed of 3.2 Km/h on a 12% slope); b) the resting ankle/arm pressure ratio was unchanged, but a significant increase was observed when the ratio was measured after exercise between stages 1 and 3; c) fibrinogenemia was significantly reduced between stages 1 and 2. Out of 18 subjects studied, 8 exceeded an MWD of 640 metres (maximum limit of exercise test which was suspended after 12'), 3 became asymptomatic, and 1 showed a significantly reduced capacity to walk. The paper concludes that, although it is necessary to obtain a confirmation from controlled studies, indobufen therapy and regular physical exercise represent an efficacious therapeutic approach, even over a long-term period, to stage II chronic arteriopathies of the lower limbs.

Aged↗
PubMedDate not supplied

[Intermittent claudication of the legs: what can be obtained without pharmacologic agents].

Intermittent claudication of the lower limbs is treated routinely by either drugs, percutaneous transluminal angioplasty, surgery or a combination of these. Each of these therapeutic approaches carries a certain risk; side effects can develop. Moreover, often there is a lack of well controlled studies to evaluate the objective basis of the results. Therefore, in the present paper, evolution of walking distance in patients presenting with intermittent claudication was followed during non-pharmacological treatment mainly consisting of daily muscle training and avoiding to use nicotine.

Chronic Disease↗
PubMedDate not supplied

Evaluation of non-invasive haemodynamic parameters in patients with intermittent claudication subjected to physical training.

In a group of 26 patients, all smokers (mean age 56.9 +/- 8 years), with intermittent claudication due to arterial obliterative disease. We investigated some of the haemodynamic, haematologic and clinical parameters before and after a 3 months physical training program. During the training period, none of the patients were given vasoactive, anticoagulant, antiaggregant or other drugs which could affect blood lipid. Patients were instructed to walk for a minimum period of 1 hour daily, in addition to normal everyday activities. Statistically significant differences of claudication pain distance were obtained: 177 +/- 88 m vs 107 +/- 40 m, +65% (p less than 0.001); maximal walking distance: 456 +/- 205 m vs 250 +/- 138 m, +82% (p less than 0.0001) determined during treadmill test at 2 mph up 12% and t/2 peak flow: 30 +/- 11.6 sec vs 46.3 +/- 32.3 sec (p less than 0.02), determinated with plethysmographic venous occlusion strain-gauges studies. An important, but not significant decrease of fibrinogen was obtained: 302 +/- 60 mg% vs 328 +/- 57 (p = 0.06), whereas no statistically significant differences were found for the more important haemodynamic parameters: (1) Widsor index determinated before (60 +/- 14% vs 58 +/- 15%) and after (26 +/- 17% vs 26 +/- 17%) treadmill-test with Doppler ultrasound; (2) peak-flow (10.5 +/- 2 ml/100/min vs 10.2 +/- 3); (3) time to peak-flow (17 +/- 10.5 sec vs 19.3 +/- 12.1). We also didn't find any significant differences in total cholesterol (227 +/- 53 mg% vs 228 +/- 48) and haematocrit (43.6 +/- 3.5% vs 43.5 +/- 3.1).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Blood and plasma viscosity and the distance of intermittent claudication in patients with type II diabetes and thrombophlebitis].

In 49 patients with insulin-resistant diabetes, with ischaemia of the lower extremities blood viscosity was measured at low coagulation rates and plasma viscosity was determined also. Moreover plasma measurements were done of total lipids, alpha-, pre-beta-, and beta lipoproteins, triglycerides, total cholesterol, free fatty acids, and, besides that, the hematocrit was measured. Immediately after blood sampling for rheological and biochemical investigations the distance of intermittent claudication was measured. A rather considerable increase of blood and plasma viscosity was noted in the patients in comparison with controls, other findings included disturbances of lipid metabolism, increased fibrinogen level, and a negative correlation between the distance of intermittent claudication and blood and plasma viscosity.

Aged↗
PubMed1990

Important predictors of the outcome of physical training in patients with intermittent claudication.

Hemodynamic and endocrine variables have been unsuccessful to predict improvement in walking distance in patients with intermittent claudication following structured training programs. In the present study we evaluated the predictive value of a number of hemodynamic and endocrine parameters. In addition we included information on cognitive factors such as stress and the belief in the structured training and motivation to participate. Twenty-five elderly subjects were studied. Significant improvement in overall walking distance was achieved. The most important explanatory variables of relative improvement in walking distance were belief in training, initial walking distance and number of smoke years. The results support the belief that cognitive factors are of major importance in predicting functional effects of structured training programs for patients with intermittent claudication.

Aged↗
PubMed1987

Effect of ketanserin in the treatment of patients with intermittent claudication: results from 13 placebo-controlled parallel group studies.

The effect of ketanserin on intermittent claudication was assessed in 13 placebo-controlled parallel group studies following basically the same protocol. After a single-blind placebo run-in period of 1-2 months, the patients randomly received either ketanserin (n = 152) or placebo (n = 158) for 3-6 months. Data on walking distance, assessed on the treadmill, were available in 12 centers (239 patients). Walking distance significantly increased in seven centers with ketanserin and in two centers with placebo. In two centers, the intergroup comparison between ketanserin and placebo was significantly in favor of ketanserin; in one center, it was in favor of placebo. A pooled analysis of all data on walking distance showed that ketanserin significantly increased walking distance by 65%, whereas placebo significantly increased it by 25%. However, the intergroup comparison does not show significant differences. Comparison of individual responses, on the other hand, showed that more patients experienced a doubling of walking distance on ketanserin than on placebo (25 versus 13%), and fewer patients deteriorated on ketanserin than on placebo (23 versus 32%); this difference in response rate is significant (p less than 0.05). In these studies there was a striking difference in drop-out rate between ketanserin and placebo. In total, 25 patients dropped out during placebo treatment versus 14 during ketanserin treatment. Nine of the 25 dropouts on placebo suffered severe "cardiovascular events," whereas no such events were observed in the ketanserin group. This difference is highly significant and suggests that ketanserin may have a vascular protective effect in patients with intermittent claudication. This possibility is being investigated in a prospective trial (PACK trial).

Blood Pressure↗
PubMed1989

Walking ability and ankle systolic pressures: observations in patients with intermittent claudication in a short-term walking exercise program.

Walking ability and limb hemodynamics were studied in 56 patients with intermittent claudication in an exercise program. Patients walked 1 hour 3 times a week for 3 to 6 months. Ankle and brachial pressures were measured at rest and after a standard walk, and walking ability on the treadmill and during free walking was determined. Average maximal distance on the treadmill increased from 0.59 to 1.00 km after training (p less than 0.0001). Also, after training 84% of patients were able to walk continuously more than 2 km without severe discomfort. The attained walking ability of individual patients could not be predicted from pressure measurements. Small pressure changes after training suggested that factors other than increased development of collateral vessels were important in determining walking ability. Practically useful walking ability was achieved in patients with aortoiliac and femoropopliteal arterial obstruction in the presence or absence of coronary disease and in patients taking beta-blockers. The results indicate that walking exercise is a valuable treatment for many patients with claudication who are not candidates for arterial reconstruction.

Ankle↗
PubMed1989

[Comparison of the effectiveness of intra-arterial and intravenous administration of buflomedil in patients with intermittent claudication].

Buflomedil is a vasoactive agent widely used in the treatment of peripheral arterial disease. 42 patients with peripheral obliterative arterial disease (POAD) in the intermittent claudication stage were treated in a randomized controlled study with 200 mg Buflomedil either intraarterially or intravenously. The infusions with this vasoactive agent were given daily for 15 days, on weekends the patients took 300 mg Buflomedil orally twice. Painfree walking distance on a treadmill was below 75 m at entrance. The treatment was controlled by treadmill test and systolic blood pressure gradients. The painfree walking distance was improved in the i.v. group from 38.7 to 91.7 m (+137%); in the i.a. group from 43.4 to 126m (+190%). There was a significant difference between the increases of painfree walking distances in both groups. No changes of doppler gradients occured. The result of this controlled study confirm that i.a. administered Buflomedil increases painfree walking distances more pronounced than i.v. infusions in patients with intermittent claudication due to POAD.

Clinical Trials as Topic↗
PubMed1989

Acenocoumarol and pentoxifylline in intermittent claudication. A controlled clinical study. The APIC Study Group.

The efficacy and safety of pentoxifylline (400 mg tid orally) and acenocoumarol, administered singly or in combination, in the treatment of intermittent claudication associated with chronic occlusive arterial disease were evaluated in a multi-center, randomized, factorial, blind clinical trial involving 146 patients. The response to treatment was assessed by measuring pain-free walking time on the treadmill and by Doppler ankle/arm systolic pressure ratio at rest and after treadmill. Both pentoxifylline and acenocoumarol were significantly more effective than placebo in increasing the proportion of patients who improved their performance on the treadmill after one year of treatment. Benefit from active treatment was also apparent from the results of Doppler examinations performed after physical exercise. No significant differences were observed in comparing the effect of one active drug versus the other or versus the combined treatment. Five major hemorrhagic complications were registered in anticoagulated patients, two fatal cerebral hemorrhages and one gastrointestinal bleeding occurring in the group treated with both active drugs. The investigators conclude that (1) pentoxifylline is effective and safe in the treatment of patients with intermittent claudication (2) the benefits of oral anticoagulant therapy are outweighed by the risk of serious bleeding, and (3) the risk of bleeding is probably increased by the combined treatment with pentoxifylline.

Acenocoumarol↗
PubMed1989

Ticlopidine in the treatment of intermittent claudication: a 21-month double-blind trial.

After a 3-month, single-blind, run-in period, 151 patients with intermittent claudication were randomly allocated to receive the antiplatelet agent ticlopidine (250 mg twice per day) or an identical placebo. One hundred and twenty patients completed the double-blind phase of the trial, which lasted 21 months. The primary analysis was performed according to the "intention-to-treat principle" in all 151 enrolled patients. There was, continuing on from the third month after randomization, a progressive and sustained improvement of the pain-free and maximum walking distances in the two treatment groups that was significantly greater in the ticlopidine group. The ankle-arm systolic blood pressure ratio at rest and after exercise increased in a significant manner in the ticlopidine group only. In a secondary analysis, with exclusion of 25 patients because of protocol violations at selection, consistently significant differences in favor of the ticlopidine group were still observed for maximum walking distance and systolic ankle-arm blood pressure ratio, both at rest and after exercise. No major side effects were reported in the treated group. It is concluded that long-term treatment with ticlopidine improves walking ability and ankle systolic blood pressure in patients with claudication.

Blood Pressure↗
PubMedDate not supplied

Ketanserin in intermittent claudication. A double-blind placebo-controlled study.

Twenty patients with intermittent claudication and having an ankle/arm blood pressure ratio less than or equal to 0.75 were randomized to receive ketanserin 40 mg b.i.d. or placebo for three months under double-blind conditions following a six-week run-in period. A placebo was administered for an additional six weeks at the end of the double-blind phase. Results indicated that ketanserin significantly increased (p less than 0.04) the pain-free walking distance by 36% versus a non-significant 10% rise with placebo. During the run-out period, this parameter remained significantly increased (p less than 0.04) with ketanserin. Changes in the total walking distance during the double-blind period were 15% and 11% for ketanserin and placebo, respectively, with a significant (p less than 0.05) increase to 30% occurring in the ketanserin group during the run-out phase. There was a decrease in the ankle/arm blood pressure ratio in the worst leg in both groups. The rise of systemic blood pressure after exercise was attenuated with ketanserin. Side-effects were reported in only one patient in the placebo group. These data indicate that ketanserin may be of value in patients suffering from intermittent claudication. Other studies are, however, warranted to determine whether this beneficial effect is general or restricted to a subgroup of patients.

Aged↗
PubMed1989

The effect of six months intensive physical training on the circulation in the legs of patients with intermittend claudication.

Out of 94 patients with intermittent claudication 65 completed a program of 6 months intensive physical training. Every 2 months the blood pressure indices at the thigh and at the ankle and the blood flow in the calf were measured at rest, after 5 min arterial occlusion and after exercise of the calf muscles until claudication. First the reproducibility of the blood pressure indices and the blood flow values was established. An increase of 15 in the pressure indices was considered to be substantial. An increase of 6.0 ml/100 ml/min in flow values was considered a substantial change. The blood pressure indices did not increase significantly during the training period, the blood flow values increased significantly. On the basis of the non-invasive tests no reliable statement can be made as to the expected result of the training.

Aged↗
PubMed1988

Buttock claudication from isolated bilateral internal iliac arterial stenoses.

An unusual case is reported of severe buttock claudication in a woman with normal ankle systolic pressures after exercise, for which the cause was eventually found to be isolated bilateral hypogastric arterial stenosis. Although a normal ankle pressure response to exercise usually rules out vascular obstruction in patients with symptoms suggestive of intermittent claudication, the diagnosis of isolated hypogastric arterial disease should be entertained when a neurogenic or orthopedic explanation can be excluded.

Adult↗