Refers to the occurrence of leg pain, aching, cramping, or fatigue triggered by walking and relieved by rest.
It is a manifestation of reduced arterial perfusion of the lower extremities.
Intermittent claudication, also known as vascular claudication.
It describes muscle pain on mild exertion with ache, cramp, numbness or sense of fatigue, classically in the calf muscles, which occurs during exercise, such as walking, and is relieved by a short period of rest.
It is classically associated with early-stage peripheral artery disease.
It can progress to critical limb ischemia unless treated.
One of the hallmarks of arterial claudication is that it occurs intermittently.
The discomfort disappears after a very brief rest and the patient can start walking again until the pain recurs.
The following signs are general signs of atherosclerosis of the lower extremity arteries:
Cyanosis atrophic changes like loss of hair, shiny skin decreased temperature decreased pulse redness when limb is returned to a “dependent” position (part of Buerger’s test)
Ischemic findings Pain Pallor (increased) Pulse (decreased) Perishing cold Parenthesis Paralysis
Intermittent claudication is a symptom of peripheral artery disease (PAD), characterized by pain or discomfort in the legs, typically in the calf muscles, that occurs during physical activity and is relieved by rest. Here’s a brief overview:
Risk factors
Smoking Diabetes High blood pressure High cholesterol Age (over 50) Obesity Family history of PAD or cardiovascular disease
Diagnosis:
Physical examination Ankle-brachial index (ABI) test Ultrasound or angiography in some cases
Treatment
Lifestyle changes (quitting smoking, exercise, healthy diet) Medications to improve blood flow or manage risk factors In severe cases, angioplasty or bypass surgery
If left untreated, it can lead to critical limb ischemia, increasing the risk of amputation
Exercise can improve symptoms.
Supervised exercise improves maximum walking distance and pain-free walking distance more than home based exercise.
Pharmacological options exist.
Medicines that control lipid profile, , and may increase blood flow to the affected muscles and allow for increased activity levels. inhibitors, such as and agonists, antiplatelet agents, antiplatelet agents, and selective PDE3 inhibitors are used for the treatment of intermittent claudication.
However, medications will not remove the blockages from the body, improve blood flow to the affected area.
Interventional procedures to remove or push aside the arterial blockages are the most common procedures for catheter-based intervention.
These procedures can be performed by interventional radiologists, interventional cardiologists, vascular surgeons, and thoracic surgeons, among others.
Surgery is the last resort can be performed either as endarterectomies on arterial blockages or perform an arterial bypass.
Atherosclerosis affects up to 10% of the Western population older than 65 years and for intermittent claudication this number is around 5%.
Intermittent claudication most commonly manifests in men older than 50 years.
When intermittent claudication is used to define peripheral arterial disease, it leads to an under estimation of the prevalence of the disease.
Intermittent claudication is considered the classic symptom of peripheral artery disease.