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.

SourceResearch connectionFrom yearThrough year

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

At least 775 records · Page 43Linked to original sources

PubMed1990

Percutaneous angioplasty of the superior gluteal artery in the treatment of buttock claudication.

A 65-year-old man developed bilateral buttock claudication due to stenosis of the main stem of the left internal iliac artery and stenoses of the left and right superior gluteal branches of the internal iliac arteries. These stenoses were successfully dilated by percutaneous angioplasty using coronary angioplasty equipment. Percutaneous angioplasty is shown to be an effective method of treatment of buttock claudication caused by stenoses of the internal iliac and superior gluteal arteries.

Aged↗

PubMed1990

A double-blind trial of Dextran-haemodilution vs. placebo in claudicants.

Haemodilution is often recommended for peripheral arterial disease, yet little data is available to support its clinical efficacy. This study was designed to prove or disprove the effectiveness of Dextran-haemodilution in intermittent claudication. Twenty claudicants with long, well-collateralized arterial occlusions were randomized into groups 1 and 2. Group 1 received isovolemic haemodilution with Dextran 40 (500 ml per session) during 3 weeks, which was followed by a wash-out period, followed by placebo treatments for 3 weeks. In group 2 this sequence was reversed. Pain-free and maximal walking distances were measured by standardized treadmill tests along with plethysmographic blood flow, Doppler pressures, haematocrit, blood and plasma viscosity as well as fibrinogen. Walking distances increased significantly by about 50% during haemodilution in both groups. This was paralleled by a fall in haematocrit and blood viscosity. All other variables remained constant. During placebo treatments there were no significant changes of any variable. The treatment was tolerated without complications. Thus Dextran-haemodilution seems safe and effective in selected peripheral occlusive arterial disease (POAD) patients. Potential responders might be identifiable before the start of therapy by angiographic investigations. The clinical effectiveness of Dextran 40 is comparable to that of hydroxyethyl starch 200 as reported in the literature.

Adult↗

PubMed2006

Brace treatment of spinal claudication in an adult with lumbar scoliosis--a case report.

UNLABELLED: Although spinal claudication may arise from narrowing of the spinal canal, not all patients with narrowing develop symptoms. The reason why some patients develop symptomatic stenosis and others do not is still unknown. Therefore, the term lumbar spinal stenosis refers to a clinical syndrome of lower extremity pain caused by mechanical compression on the neural elements or their blood supply. Some studies have shown effectiveness of brace treatment with a common supportive LSO. At our Centre the sagittal realignment brace is used for the treatment of chronic low back pain. This is a lumbar lordosing brace theoretically leading to a reduction of the volume in the spinal canal. However a patient with a significant increase in walking distance due to the application of this brace will be presented here. MATERIAL AND METHOD: A 47 year old woman with a 55 degrees lumbar scoliosis, 30 degrees upper lumbar kyphosis and with highest pain levels under medication (Durogesic 25 mg, Ibuprofen 800, Mirtazapin 15 mg) has been treated with a sagittal realignment brace. Self reported walking distance was at around 800 steps before the pain appeared unbearable (since 5 years). Self reported walking distance was recorded (Patients counts) in the brace 2 days and 10 days after adjustment. RESULTS: Walking distance increased to 8000 steps after 2 days and to 12000 after 10 days while pain intensity decreased only one point in the VRS, however without any further medication. CONCLUSIONS: In contrary to current hypotheses about the aetiology of spinal claudication augmentation of lordosis may lead to a significant improvement of symptoms associated with spinal stenosis and lumbar scoliosis.

Braces↗

PubMed1962

The diagnosis of ischaemic heart pain and intermittent claudication in field surveys.

Hospital studies were used to identify those characteristics of angina pectoris, cardiac infarction and intermittent claudication which most effectively distinguish these conditions from other causes of chest or leg pain. These are used to formulate precise definitions for epidemiological use and to form the basis of a standardized questionnaire.Agreement on the use of such a questionnaire would permit international comparisons of the prevalence of these conditions, as defined. This would not hinder the collection of additional information, as required in particular studies.As compared with physicians' diagnoses, the questionnaire had high specificity and reasonably good sensitivity. Interpretation of subjects' answers presents no serious difficulties. There is evidence that the diagnosis of angina pectoris presents special problems in populations with a high prevalence of chronic bronchitis.

Angina Pectoris↗

PubMed1999

Treatment of intermittent claudication with physical training, smoking cessation, pentoxifylline, or nafronyl: a meta-analysis.

BACKGROUND: There is no consensus on the efficacy of physical training, smoking cessation, and pharmacological therapy (pentoxifylline or nafronyl oxalate) in the treatment of patients with intermittent claudication at Fontaine stage II of disease. METHODS: A MEDLINE and manual search was used to identify relevant publications. Uncontrolled or retrospective studies, double reports, and trials without clinically meaningful outcomes were excluded. Included studies were graded level 1 (randomized and double- or assessor-blind), level 2 (open randomized), or level 3 (nonrandomized). Pain-free and total walking distance were the main outcomes considered; when feasible, end-of-treatment results were combined with appropriate meta-analytical procedures. RESULTS: In 5 level 2 studies, physical training increased pain-free and total walking distance significantly (139.0 m [95% confidence interval {CI}, 31.0 to 246.9 m] and 179.1 m [95% CI, 60.2 to 298.1 m], respectively). In a level 3 study, smoking cessation resulted in a nonsignificant increase in total walking distance of 46.7 m (95% CI, -19.3 to 112.7 m). In 6 level 1 studies, pentoxifylline increased both pain-free and total walking distance by 21.0 m (95% CI, 0.7 to 41.3 m) and 43.8 m (95% CI, 14.1 to 73.6 m), respectively. In 4 level 1 trials, nafronyl significantly increased pain-free walking distance (58.6 m [95% CI, 30.4 to 86.8 m]) and total walking distance (71.2 m [95% CI, 13.3 to 129.0 m]). CONCLUSIONS: Physical training increased pain-free and total walking distance in level 2 studies. Only level 3 studies support the usefulness of smoking cessation. In level 1 studies, pentoxifylline and nafronyl increased pain-free and total walking distance, but the average effects were relatively small.

Clinical Trials as Topic↗

PubMed1998

Recruitment curve of the soleus H reflex in patients with neurogenic claudication.

The diagnosis of neurogenic claudication (NC) remains uncertain when no definite signs of radicular lesions are found in electrophysiological testing. However, the functional deficit could be demonstrated during the brief time in which the patients complain of pain and weakness in the muscles of the lower limbs after walking. We have used electrophysiological testing of the H reflex and the F wave to document the transient functional derangement expected to occur at the radicular level in patients with NC after walking. We examined the recruitment curve of the soleus H reflex, and the chronodispersion of the posterior tibial nerve F wave, at rest and after a walking exercise that triggered their symptoms in 10 patients with NC, with no positive electrophysiological findings of radicular lesion. The same studies were performed in 5 age-matched healthy volunteers, used as control subjects, who were asked to walk for 30 min. At rest before walking, no abnormalities were found in any of the patients. After walking, the H wave showed a transient increase in its threshold with respect to that of the M wave in 7 patients (70%). Such abnormality lasted for a mean period of 7 min. In 2 of these patients there was also an increase in the F-wave chronodispersion. Our data suggest that nerve conduction is transiently blocked in large myelinated fibers at a radicular level in patients with NC after walking. Partial interruption of the H-reflex circuit could be one of the pathophysiological mechanisms underlying NC.

Adult↗

PubMed1980

A controlled trial of naftidrofuryl (Praxilene) in the treatment of intermittent claudication.

We present the results of a double-blind trial of naftidrofuryl (Praxilene) in the treatment of intermittent claudication. One hundred and twenty-eight patients were subjected to a standard walking test 3 and 6 months after treatment. There was no significant objective improvement attributable to the drug. Although both groups significantly increased their walking time to the onset of pain, those patients over 60 years old taking naftidrofuryl showed a significant improvement over their pretreatment walking times to onset of pain, whereas their controls did not.

Ankle↗

PubMed1980

The effect of naftidrofuryl (Praxilene) on intermittent claudication.

In a randomized double-blind controlled trial the effect of naftidrofuryl (Praxilene) 200 mg t.d.s., taken for 6 months, was compared with placebo in intermittent claudication. Whilst there was a significant subjective improvement regardless of age or treatment, patients over 60 on naftidrofuryl experienced a more rapid symptomatic relief than other patients. At six months this age group showed a significant improvement over the placebo group. There was no significnat objective evidence of improvement.

Aged↗

PubMed1980

Femoropopliteal vein grafts for intermittent claudication.

Femoropopliteal vein grafts were performed for intermittent claudication in 160 patients (182 legs) over a 12-year period. The accumulative patency rate was 67 per cent at 5 years. However, patency rates improved significantly in the latter 6 years of the study, to 75 per cent at 5 years. Early postoperative occlusion and morbidity rates also markedly declined in this latter period. Patency rates were significantly better in males than in females, in patients who were able to stop smoking after operation and in legs with a three-vessel run-off compared with those with a two- or one-vessel run-off. The patients' age did not influence graft patency rates.

Adult↗

PubMed1982

A double-blind trial of suloctidil v. placebo in intermittent claudication.

In a recent double-blind trial lasting over 6 months, 40 patients suffering from intermittent claudication were randomly allocated to receive 300 mg of suloctidil per day or exactly matching placebo capsules. In addition to treadmill walking distance, other objective criteria including ankle blood pressure response and muscle blood flow measured by 133Xe clearance were used to assess the effectiveness of therapy. Nine patients (4 in the suloctidil group and 5 controls) did not complete the trial according to the protocol. Of the remaining 31 patients, 17 were in the control group and 14 received suloctidil. A significant improvement in the absolute walking distance, the level of beta-thromboglobulin (beta TG) compared to pre-therapy value and the time for the ankle pressure index to return to the pre-exercise value was observed in patients receiving suloctidil.

Adult↗

PubMed1992

Screening patients with claudication from femoropopliteal disease before angioplasty using Doppler colour flow imaging.

Time, expense, risk and discomfort are incurred by arteriography in patients with intermittent claudication who might be candidates for percutaneous transluminal angioplasty (PTA). A valid screening technique could reduce the need for arteriography in patients found to have lesions not amenable to PTA. Agreement between Doppler colour flow imaging (DCFI) and angiography for detecting haemodynamically significant lesions is high, but DCFI may not identify lesions suitable for angioplasty. A total of 36 limbs in 30 patients were studied using DCFI before angiography. Agreement between the two methods was excellent (kappa = 0.91), and the predictive accuracy of DCFI for lesions amenable to PTA was good (kappa = 0.78, sensitivity 94 per cent, specificity 85 per cent, positive predictive value 83 per cent, negative predictive value 94 per cent, overall accuracy 89 per cent). DCFI is a useful screening process that may prevent unnecessary angiography, with consequent financial savings and clinical benefit.

Aged↗

PubMed2003

An unusual cause of claudication.

We describe a case of a patient who presented with claudication 3 months following a coronary angiogram in which the femoral arterial puncture site had been closed with an AngioSeal. The lesion was found to be due to the anchor of the AngioSeal, which embolized during attempted percutaneous revascularization and had to be snared and retrieved to the level of the sheath in the left femoral artery and was then surgically removed.

Cardiac Catheterization↗

PubMed2005

Percutaneous transluminal angioplasty of infrapopliteal arteries in patients with intermittent claudication: acute and one-year results.

In advanced stages of infrapopliteal peripheral arterial occlusive disease with critical ischemia of the lower limb, the efficacy of percutaneous transluminal angioplasty (PTA) is well established. In contrast, PTA is currently not the therapy of choice in intermittent claudication (IC). In this prospective study, patients with IC were treated percutaneously. Technical aspects and long-term results are presented. In 78 patients (61 males, or 78.2%; age, 71 +/- 11 years) with IC (Rutherford grade 2 or 3), 104 interventions were performed. At baseline, the initial/absolute walking distance (IWD/AWD) was 49 +/- 34/102 +/- 88 m; the ankle-brachial index (ABI) was 0.61 +/- 0.2 before and 0.49 +/- 0.2 after exercise. A crossover approach was used in 74% and an antegrade access in 26% of the cases. In 19 interventions (18.3%), the excimer laser technique was used, and in 26 interventions (25%) a total of 39 stents were implanted. Procedural success rate was 89.4%. IWD and AWD improved to 107 +/- 67 m and 167 +/- 74 m (P < 0.0001 vs. baseline each), respectively, and the ABI at rest and after exercise increased to 0.88 +/- 0.13 and 0.72 +/- 0.19 (P < 0.0001 vs. baseline each). Six complications occurred (5.8%). One embolic occlusion, two minor groin hematoma, one arteriovenous fistula, one compartment syndrome, and one perforation. All were treated conservatively. After 12 months, the primary patency rate was 66.3%, cumulative primary assisted patency rate was 81.9%, and secondary patency rate was 91.5%. Percutaneous revascularization of infrapopliteal arteries in patients with IC is feasible and associated with good acute clinical results and an encouraging long-term patency rate. The complication rate is low.

Aged↗

PubMed2002

Measuring treatment effects of cilostazol on clinical trial endpoints in patients with intermittent claudication.

Intermittent claudication (IC) comprises the most common presenting symptoms of peripheral arterial disease (PAD), which itself is a manifestation of systemic atherosclerosis. Typical symptoms of IC are aching pain, numbness, and fatigue in the lower extremities. Symptoms are induced by walking or exercise and usually resolve with rest. The cornerstone of treating IC is risk-factor reduction and a supervised exercise regimen. Pharmacotherapy specifically indicated for the treatment of IC includes a new drug, cilostazol, and the traditional drug, pentoxifylline. Cilostazol also has antiplatelet, antithrombotic, and vasodilatory activity, as well as a positive effect on serum lipids. Eight multicenter clinical trials, seven in the U.S. and one in the U.K., used objective and subjective clinical endpoints to assess the treatment efficacy of cilostazol. Objective endpoints included maximal and pain-free walking distance (MWD and PFWD, respectively), the ankle-brachial index, peripheral hemodynamic measurements, and serum lipid levels. Subjective endpoints, assessed by patient questionnaires, included perceived functional status and health-related quality of life. Cilostazol treatment showed statistically significant increases in MWD and PFWD within 4 weeks, as well as improvements in physical functional status at 24 weeks, compared with placebo and pentoxifylline. Increases in high-density lipoprotein cholesterol and decreases in plasma triglycerides were also noted. Subjective assessments appeared to match objective parameters.

Aged↗

PubMed1975

Controlled trial of propranolol in intermittent claudication.

Seven patients (5 with arteriosclerosis obliterans and 2 with Buerger's disease) completed a two-phase double-blind crossover trial of propranolol in intermittent claudication. Performance was measured on a moving treadmill. In the initial phase, the patients were hospitalized in order to determine an "effective" dose of propranolol. Improvement was noted in all: after 1,600 mg in 5 and after 240 mg and 600 mg in the others. The controlled phase was carried out on an outpatient basis over 8 weeks, the patients receiving propranolol and placebo in a random manner, each for two 2-week periods. Comparison of matched periods of drug and placebo revealed no advantage for propranolol. Patients' performances deteriorated with time. None of the patients evidenced deterioration of occlusive peripheral arterial disease that could be attributed to propranolol, in spite of the high doses used.

Adult↗

PubMed1993

Intermittent claudication of the spinal cord due to ossification of the ligamentum flavum. A report of two cases.

Two patients are described who developed intermittent claudication of the spinal cord which caused spastic paraparesis during walking. The cause in both was multi-level ossification of the ligamentum flavum. Epidural spinal cord evoked potentials showed disappearance of the third negative component in one case, and positive-going waves in the most compressed area. Both patients had excellent neurological improvement after resection of the ossified ligament.

Adult↗

PubMed1996

Vertebral hemangioma presenting with intermittent claudication.

The case of a patient with vertebral hemangioma and unusual clinical presentation is reported, with an attempt to explain these unusual clinical complaints. Vertebral hemangioma is a common and often asymptomatic tumor. Neurologic symptoms may appear due to pressure on the neural tissue caused by extraosseous extension. The patient reported here presented with intermittent claudication. Conventional radiography CT, and MRI revealed vertebral hemangioma at T5 and extraosseous extension compressing the spinal cord. Gravity-related vascular dilatation may induce further compression of the spinal cord and, thus, is thought to be the underlying event in the induction of the intermittent clinical symptoms. The lesion was treated with subtotal corpectomy after embolization and fusion with a strut iliac crest graft. At the 9-month follow-up, the patient was without complaints. We conclude that a diagnosis of vertebral hemangioma should be considered in cases of intermittent neurologic symptoms of the lower extremities.

Adult↗

PubMed1987

Clinical effects of intravenous iloprost in patients with intermittent claudication.

In a randomized patient-blind study iloprost or hydroxy-ethyl starch 200/0.5 were given i.v. 5 h daily for 2 weeks to 24 patients suffering from severe intermittent claudication due to peripheral vascular disease. An increase in pain-free walking distance of more than 50% occurred in 6 of 11 patients after the iloprost infusions and in 7 of 12 patients after HES treatment. No significant effects on haemodynamic or clinical chemistry tests were observed.

Aged↗