Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Intermittent 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 19 recordsLinked to original sources
PubMed1990

Peripheral arterial occlusive disease: conservative treatment of intermittent claudication.

Intermittent claudication is the principal symptom in stage II of peripheral arterial occlusive disease. As this is a multilocular manifestation of atherosclerosis, a distinction must be drawn between treatment of the underlying disease with consideration of the individual risk factors and improvement and abolition of the intermittent claudication. Various therapeutic principles exist, and drug therapy is the subject of controversial discussion. On the basis of eight controlled, randomized studies, it was demonstrated that in comparison with placebo a statistically significant increase in the pain-free walking distance can be achieved by oral drug administration within 3-6 months. This drug therapy should be considered for those patients with intermittent claudication who cannot undergo revascularization, angioplasty, or walking training.

Aged↗
PubMed1978

Drug therapy in intermittent claudication: an objective assessment of the effects of three drugs on patients with intermittent claudication.

It has been suggested that, by reducing the viscosity of blood, flow through capillaries is increased with consequent improvement in the symptoms of patients with peripheral vascular disease. We examined the effects of treatment with drugs purported to reduce blood viscosity to test the validity of this claim. Measurements of viscosity and the rate of blood flow to the leg were made in a group of patients before and after treatment with three different drugs--tetranicotinoylfructose (Bradilan), oxypentifylline (Trental) and cinnarizine (Stugeron). All patients had intermittent claudication in one leg and the distribution of arteriosclerosis was similar in each patient. After treatment there was little or no change in blood viscosity and no change in the rate of flow recorded in the symptomatic legs. We did not find any objective evidence to support the use of these drugs in patients with intermittent claudication.

Aged↗
PubMed1975

[The concept of neurogenic intermittent claudication. A rare form of intermittent limping in neurologic system disease].

Two cases of neural muscular atrophy of the Charcot-Marie-Tooth-Hoffmann type with strain-dependent pain in the leg similar to intermittent claudication are reported. While the pathogenesis of a neurogenic intermittent claudication appears to be reasonably explained by a pathological narrowness of the lumbar spinal duct, this question must remain open in the cases of neurospinal systemic disease described.

Arterial Occlusive Diseases↗
PubMed1979

Intermittent claudication--pathophysiological considerations.

Intermittent claudication is a non-pathognomic symptom elicited by an inbalance between the metabolic demands of the exercising skeletal muscle and its blood supply. In normal conditions hyperemia to the working muscles will be impaired during the exercise by mechanical compression of the microvessels. The resulting anaerobic metabolism will cause further vasodilatation. Both phenomena (exercise and reactive hyperemia) contribute to a maximal increase in local blood flow as soon as the exercise is stopped. If the local circulation is impaired by occluding arterial disease (eventually complicated by aggravating factors) the tolerance to skeletal work is lowered and the circulatory reserves are entirely exhausted as demonstrated by the ischemic exercise-test. In the case of a major obstruction and poor collateralisation, a "steel phenomenon" may occur. The pharmacotherapeutic possibilities to cope with in this situation are briefly discussed.

Adenosine Triphosphate↗
PubMed1979

The management of intermittent claudication.

Many patients with intermittent claudication improve due to development of collateral vessels. Only a small proportion worsen, and few progress to severe ischaemia with the risk of amputation. Accordingly, most patients can be reassured and treated expectantly. Those patients have a reduced life expectancy compared with the population at large. Thus, surgical treatment should be reserved for patients who are severely restricted by claudication. The early technical results of arterial reconstruction for claudication are excellent. However, the late results are much worse in patients who continue to smoke. Nowadays, the complication rate from surgery is low.

Adult↗
PubMed1976

The fate of patients with intermittent claudication managed nonoperatively.

Of 100 patients with intermittent claudication, followed an average of six years, a surprising 78 per cent either showed improvement or remained stable regarding the presenting complaint. However, 39 per cent showed evidence of further progression of atherosclerosis. In patients with femoropopliteal occlusion in one leg, almost 40 per cent had occlusion in the one leg, almost 40 per cent had occlusion in the other leg after two to six years. The amputation rate was 7 per cent but six of these seven patients had severe diabetes. This study suggests that we are not causing limb loss by adhering to stringent criteria for bypass grafting. It also suggests that the patient with intermittent claudication without associated grave signs has a better than 50 per cent chance of improving and a better than 60 per cent chance that his disease will not show evidence of significant progression during a five to six year period. Such data should be taken into consideration when patients are considered for arterial reconstruction.

Adult↗
PubMedDate not supplied

[Intermittent claudication. Synthesis and conclusions].

The intermittent claudication is a symptom. By itself, it does not justify surgical treatment. On the other hand, it is advisable when accompanied by a threat of trophic disorders. Direct arterial surgery is often necessary in the case of suprainguinal, aorto-iliac lesion, rarely in the leg. Indeed, under the inguinal area, nature tends to compensate for occlusions of the trunk by the formation of a parallel network. A logical treatment is to contribute to this tendency, by increasing the upward and downward pressure gradient through muscular exercise and lumbar sympathectomy. In practice, the choice between hyperemia surgery and reconstructive surgery rests on functional data, that make it possible to evaluate the potential of the parallel network and of the peripheral vascular bed.

Humans↗
PubMed1977

[Personality traits (type A) in patients with intermittent claudication. 1. Results of the Bortner test].

It has never been considered whether type A (coronary prone) behavior can also be found in patients with peripheral atherosclerotic disease (intermittent claudication). This question has been studied by means of the 14-item (Bortner) questionnaire. The questionnaire was filled out by 10 patients (self-assessment) with coronary artery disease and intermittend claudication, 13 with intermittent claudication alone and 10 with comparably severe, but not arteriovascular disease and independently by their wives (relative's assessment). In the self-assessment the test discriminated significantly between the three groups (Kruskal-Wallis p less than 0.05). The correlation coefficient (Spearman) between expression of type A behavior and extent of atherosclerosis was 0.3720 (p less than 0.02). In the relative's assessment the groups were also differentiated significantly (Kruskal-Wallis p less than 0.05). The correlation coefficient (Spearman) was 0.4080 (p less than 0.009). The results indicate that patients with intermittent claudication demonstrate a predilection for type A behavior, which is more pronounced in those with additional coronary artery disease. The multiple stepwise regression indicated that type A behavior is related to atherosclerosis independently of other factors.

Coronary Disease↗
PubMed1979

Neurogenic intermittent claudication in association with spondylolisthesis.

In the last three decades, more attention has been put upon neurogenic intermittent claudication, also called pseudoclaudication. The syndrome usually develops in patients with congenital narrow spinal canal and secondary additional narrowing. Two cases of spondylolisthesis with neurogenic intermittent claudication are presented. The pathogenesis, symptoms and findings of neurogenic intermittent claudication are discussed.

Female↗
PubMed1975

Phenol sympathectomy in the treatment of intermittent claudication: a controlled clinical trail.

Twenty-five patients with intermittent claudication were randomly allocated to treatment either by injection of phenol into the lumbar sympathetic chain or by injection of local anaesthetic subcutaneously. On the day after the injection, sympathectomy, assessed by skin temperature change, was achieved in 85 per cent of the phenol group. At 1 month subjective improvement was claimed by 45 per cent of the patients in the sympathectomized group and by 64 per cent in the control group; at 3 months the figures were 25 and 45 per cent respectively. Treadmill testing at two exercise loads showed no significant difference in claudication distance or stopping time between the two groups. Calf blood pressure response following exercise was not affected by sympathectomy. There is no subjective or objective evidence that phenol sympathectomy improves intermittent claudication.

Blood Pressure↗
PubMed1975

Intermittent claudication: its natural course.

Of more than 600 patients seen for intermittent claudication by this group and not primarily considered for surgery, 104 had angiographic studies and are the basis for this report. The follow-up period varied from 6 months to 8 years, with a mean of 2.5 years. Classification by severity of claudication revealed 33 with less than one block, 36 with two blocks, and 35 with two or more blocks, foot, calf, or thigh claudication. Eighty-two remained stable or improved and 22 worsened. Of the 22 who worsened, 16 had only worsening of claudication (six of them requiring arterial reconstruction) and six progressed to gangrene and required amputations. Of the 82, 66 either had marked improvement of claudication or remained sufficiently stable not to require any operative intervention. Sixteen required arterial reconstruction for persistent, intolerable, or incapacitating claudication. Five of the six amputees were from the less than one half block claudication group. Angiographic studies were significant only in relation to the below-knee runoff in that three of 25 with less than one vessel runoff, two of 23 with one to two vessel runoff, and one of 56 with two to three vessel runoff came to amputation, regardless of the pattern of more proximal arterial occlusions. The study suggests that intermittent claudication is relatively benign, with only 5.8 percent coming to amputation in a 2.5 year mean follow-up. Prognosis is determined by the severity of below-knee arterial involvement and apparent inability to compensate for ischemia via the collateral circulation since only 12.5 percent of those with the most pronounced involvement came to amputation.

Amputation, Surgical↗
PubMed1976

Lumbar sympathectomy in the treatment of uncomplicated intermittent claudication.

The precise role lumbar sympathectomy plays in the treatment of uncomplicated intermittent claudication continues to be debated. Past experience at this institution indicates that lumbar sympathectomy has a definite positive role in uncomplicated intermittent claudication. A critical analysis of the 86 patients included in this study adds further support to this contention. Properly selected patients who undergo complete anatomic sympathetic denervation of the lower limbs continue to have very satisfactory results, as they have since 1947 in this institution.

Adult↗
PubMed1975

Treatment of intermittent claudication. Lumbar paravertebral somatic block with phenol.

Our experience of twenty-eight patients with intermittent claudication treated by means of paravertebral lumbar somatic nerve block is presented. There was immediate demonstrable improvement in 92-5% of the twenty-six patients included in this follow up. At the end of 6 months the improvement was maintained in 72-7% of the patients and in about 70-0% of patients at 6 months and at 9 months. Six of the seven patients followed up for 1 year had a claudication distance at least twice that prior to the block. The results of this indicate that lumbar somatic nerve block is less disturbing and more effective than other forms of conservative treatment for intermittent claudication.

Aged↗
PubMed1975

Calf blood flow in intermittent claudication.

Calf blood flow was correlated with severity of symptoms in 24 patients with intermittent claudication. Calf blood flow was measured (Whitney strain gauge) at three levels of demand--at rest, after exercise ("open"), and after exercise with total vascular occlusion by a tourniquet about the thigh ("closed"). The results showed significant correlation between the patients' reported capacity to walk and measured exercise tolerance on an ergometer (P less than or equal to .01). The coefficients of correlation between exercise tolerance and calf blood flow (resting, postopen or postclosed exercise) or the vascular reserve (difference between postopen and postclosed exercise hyperemia) were not significant. It is concluded that capacity for walking in cases of intermittent claudication is not a reliable index of the calf blood flow. The relationship between these factors would be clearer if the patients pain threshold and calf tissue metabolic activity were known also.

Adult↗
PubMedDate not supplied

Behavior of calf blood flow in normal subjects and in patients with intermittent claudication during a 24-h time span.

Calf basal resting and reactive hypercemia blood flow were measured at 4-h intervals during a day in fifteen healthy subjects and in fifteen patients with intermittent claudication by means of a venous occlusion plethysmograph. Mathematical-statistical analysis of the data failed to demonstrate circadian periodicity of calf blood flow in healthy subjects, but proved the existence of a 24-h rhythm of calf basal resting and reactive hyperemia blood flow in patients with intermittent claudication. This different behavior of calf blood flow can be understood if one considers that in healthy subjects the voluntary muscles in the extremities have a blood supply which can be instantaneously adjusted over a large area. In patients with peripheral arterial disease, on the other hand, the vascular responses in voluntary muscles of the limbs to various endogenous or exogenous stimuli are impaired and reduced. The circadian rhythm observed in patients with intermittent claudication has early evening peaks and a nocturnal trough with a nadir occurring after midnight and before 0400. This rhythm displays marked similarities with those of all other circulatory values. As to the mechanism of rhythm, it is hard to decide whether or not it has an independent endogenous origin. It is known that many of the circulatory variables are interrelated and that some are clearly related to other circadian rhythms. Perhaps the rhythmic reduction of limb blood flow which occurs during the night is the mechanism underlying the nocturnal pain of subjects with limb ischemia by peripheral arterial disease.

Adult↗
PubMed1977

Treatment of severe intermittent claudication by controlled defibrination.

Fifteen patients with severe intermittent claudication were treated by therapeutic defibrination with subcutaneous injections of ancrod for 5 weeks. Mean plasma-fibrinogen was maintained below 50% of the initial value throughout the treatment period. This reduction in plasma-fibrinogen was accompanied by a parallel fall in whole-blood viscosity and a pronounced clinical improvement. Objective measurements showed maximum benefit on the 21st day of treatment, when the mean resting ankle/arm pressure index had increased by 37%, the post-exercise pressure index had increased by 50%, and the time taken for the pressure index to return to a resting value after a constant exercise had decreased by 33%. (The claudication-count had increased by 59%).

Ancrod↗
PubMed1975

The smoking habits of men with intermittent claudication.

Smoking habits among 54 male patients with intermittent claudication (IC) and 200 healthy 50-year-old men from the same county have been studied. The prevalence of smokers at the age of 50 was 98% among the IC patients against 46% among the healthy controls. The percentage of heavy smokers and the total tobacco consumptiion were not significantly different in the two groups. However, the percentage of smokers who began to smoke before the age of 15 was significantly higher in IC patients than in the healthy group, 28% to 7%.

Adult↗