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Management of claudication

Authors
Emile R Mohler III, MD
Mark G Davies, MD, PhD, MBA, FACS, FACC
Section Editors
Denis L Clement, MD, PhD
John F Eidt, MD
Joseph L Mills, Sr, MD
Deputy Editor
Kathryn A Collins, MD, PhD, FACS

INTRODUCTION

Claudication (derived from the Latin word for limp) is defined as a reproducible discomfort of a defined group of muscles that is induced by exercise and relieved with rest. The symptoms result from an imbalance between the supply and demand for blood flow due to peripheral artery disease (PAD). (See "Clinical features and diagnosis of lower extremity peripheral artery disease".)

The majority of patients with claudication have PAD; however, some patients may have claudication due to other diseases (eg, thrombosed popliteal aneurysm, popliteal entrapment syndrome), for which management differs from PAD and is discussed in separate reviews. (See "Clinical features and diagnosis of lower extremity peripheral artery disease", section on 'Differential diagnosis of PAD'.)

The management of the patient with claudication due to PAD, including medical therapy and indications for intervention, will be reviewed here. The management of limb-threatening ischemia (rest pain, ulcers, gangrene), and techniques for reconstruction and their outcomes are discussed elsewhere. (See "Surgical management of claudication" and "Percutaneous interventional procedures in the patient with lower extremity claudication".)

OVERVIEW

Once a patient is diagnosed with claudication due to peripheral artery disease (PAD), a rational approach to treatment takes into account the patient’s age and medical comorbidities, daily activities and limitations, severity of symptoms, and location and extent of disease.

Patients with claudication are classified as having mild, moderate, or severe disease in the Rutherford system, or severe (Stage 2b) claudication if walking distance is less than 650 feet (200 meters) in the Fontaine system. (See "Classification of lower extremity peripheral artery disease", section on 'Rutherford' and "Classification of lower extremity peripheral artery disease", section on 'Fontaine'.)

                        

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Literature review current through: Nov 2016. | This topic last updated: Mon Oct 17 00:00:00 GMT+00:00 2016.
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