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Surgical management of claudication

David G Neschis, MD
Michael A Golden, MD
Section Editors
John F Eidt, MD
Joseph L Mills, Sr, MD
Emile R Mohler III, MD
Denis L Clement, MD, PhD
Deputy Editor
Kathryn A Collins, MD, PhD, FACS


Intermittent claudication is due to a deficiency in blood supply to exercising muscle and is generally a reliable indicator of occlusive arterial disease. Classic intermittent claudication is a reproducible discomfort of a defined group of muscles which is induced by exercise and relieved with rest [1,2]. However, atypical leg pain is more common [2]. Most patients with intermittent claudication remain stable with medical therapy. When revascularization is required, the options are percutaneous interventional procedures and surgery.

This topic will review the general indications for revascularization in patients with claudication, and the outcomes of lower extremity bypass surgery. The roles of medical therapy, percutaneous revascularization, and the management of limb-threatening ischemia are discussed separately. (See "Management of claudication" and "Percutaneous interventional procedures in the patient with lower extremity claudication" and "Treatment of chronic lower extremity critical limb ischemia".)


The location of lower extremity pain varies with the vessels that are involved. The severity of symptoms depends upon the degree of stenosis, the collateral circulation, and the vigor of exercise. Most patients with intermittent claudication remain stable with medical therapy. When revascularization is required, the options are percutaneous interventional procedures and surgery. (See "Clinical features and diagnosis of lower extremity peripheral artery disease", section on 'Claudication'.)

The usual relationship between the site of pain and site of arterial disease can be summarized as follows:

Buttock and hip: Aortoiliac disease


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Literature review current through: Sep 2016. | This topic last updated: Apr 8, 2016.
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