Intermittent Claudication

Intermittent Claudication Risk factors

The risk factors for peripheral artery disease and claudication involve the following:

• Smoking

• High cholesterol

• High blood pressure

• Obesity (a body mass index (BMI), over 30)

• Diabetes

• Chronic kidney disease

• Age older than 70 years

• Age greater than 50 if you smoke or are diabetic

• A familial history of atherosclerosis, peripheral artery disease, or claudication

Intermittent Claudication Complications

Claudication is usually considered a warning of significant atherosclerosis in the circulatory system, indicating an elevated risk of heart attack or stroke. Additional complications of peripheral artery disease caused by atherosclerosis include:

• Skin lesions that do not heal

• Death of muscle and skin tissues or gangrene

• Amputation of a limb

Prevention

The best way to prevent or stop claudication is to maintain healthy living and control specific medical conditions. That means:

• Quit smoking if you are a smoker

• Exercise regularly

• Eat a healthy, well-balanced diet

• Maintain a healthy weight

• If you have diabetes, keep your blood sugar in good control

• Keep cholesterol and blood pressure within normal values

Intermittent Claudication Diagnosis

Claudication might go undiagnosed or unidentified because many people believe the pain to be an unwelcome but normal part of aging. Some people simply lower their activity level to circumvent the pain.

A diagnosis of claudication and peripheral artery disease is based on a review of your symptoms, a physical examination, an assessment of the skin on your damaged limbs, and tests to examine blood flow.

Some common tests used to diagnose claudication might include:

• Pulse measurement in your palms or feet to analyze blood flow to the entire limb

• Ankle-brachial index, comparison or analysis of blood pressure in your ankles with the blood pressure in your arms

• Segmental blood pressure measurement, a series of blood pressure measurements at different regions on your arm or leg to help determine the amount and location of arterial damage

• Exercise testing to determine the maximum distance you could walk or the maximum exertion without pain

• Doppler ultrasound to view the flow of blood

• Magnetic resonance imaging (MRI) or computerized tomography (CT) angiography to seek narrowed blood vessels

Intermittent Claudication Treatment

The aims of treating claudication and peripheral artery disease are to lower pain and manage the risk factors that contribute to vascular disease.

Exercise

Exercise lowers pain, increases exercise duration, improves vascular health in the damaged limbs, and contributes to weight management and an overall improvement in your quality of life.

Recommended walking programs involve:

• Walking till you feel moderate or pain

• Resting to ease pain

• Walking again

• Repeating the walk-rest-walk cycle for thirty to forty-five minutes

• Walking 3 or more days a week

• Supervised exercise is suggested for starting the treatment, but long-term exercise at home is crucial for ongoing disease management.

Medications to manage risk factors

Your primary care physician might prescribe one or more medications to control pain and manage risk factors for vascular disease. These involve drugs to manage the following:

• Pain - The drug cilostazol, which improves blood flow, might lower pain during exercise and allow you to walk further.

• High cholesterol - Statins are a type of drug that helps lower cholesterol, a key factor in the formation of plaques in arteries. Taking statins might improve the walking distance.

• High blood pressure - Various classes of drugs might be prescribed to lower blood pressure and lower the risk of heart attack or stroke.

• Other cardiovascular risks - Anti-platelet drugs, which help stop the formation of blood clots, might lower the risk of heart attack, stroke, or clots blocking blood flow to limbs. These drugs include aspirin, clopidogrel (Plavix), and other types of drugs.

Talk to your primary care physician about over-the-counter medications, supplements, or other medications that you should not take with your prescribed treatment.

Intermittent Claudication Surgery

When peripheral artery disease is serious and other interventions do not work, surgery might be needed. Options include:

• Angioplasty - This is a procedure to improve blood flow by widening an affected artery. A primary care physician guides a narrow tube through your blood vessels to deliver an inflatable balloon that expands the artery. Once the artery is widened, your primary care physician might place a small metal or plastic mesh tube or stent in the artery to keep it open.

• Vascular surgery - During this type of surgery, the primary care physician takes a healthy blood vessel from another part of your body to replace the vessel that is causing claudication. This enables blood to flow around the blocked or narrowed artery.