Intermittent claudication is. What is intermittent claudication? According to anatomical criteria, they are distinguished
Disease intermittent claudication caused by impaired blood supply in the lower extremities. If you suspect that you have intermittent claudication, the main symptom is pain that occurs in the legs when walking, stopping at rest.
Main reasons
Intermittent claudication signals a serious disease of all arteries of the body, but the disease manifests itself (obliterating endarteritis), usually in the lower extremities. The arteries narrow, sometimes almost to the point of complete closure, due to a pathological process occurring in the walls of the blood vessels. The basis of such changes is atherosclerosis. The disease can occur without symptoms for a long time, gradually progressing. However, there have been cases when it begins with an acute attack.
Intermittent claudication is a consequence not only of vascular diseases (endarteritis), but also of infection, trauma, intoxication, diabetes, etc.
Symptoms of the disease
When diagnosed with intermittent claudication, the symptoms are usually the following: first, fatigue and paresthesia in the legs, then pain appears when walking, becoming more persistent over time. With this disease, the pulse disappears most often on the foot, sometimes the disappearance of the pulse is observed in the fossa under the knee, the color of the skin changes (turns pale, and later appears cyanotic). The temperature of the foot and toes decreases, sensitivity is lost, the foot is usually always cold, the calf muscles hurt, as well as the nerve trunks of the legs (when pressure is applied to them). Trophic ulcers may occur on the feet. This is a chronic disease with remissions.
Intermittent claudication syndrome most often occurs in 30-40 year old men, but now women are also starting to get sick. Doctors explain this by the habit of smoking, which provokes endarteritis and is a huge risk factor.
Therapy
If you suspect that you have intermittent claudication, treatment should begin immediately. First, diagnosis is recommended using modern methods, for example, ultrasound, rheovasography, x-ray examination of the arteries (angiography). If the diagnosis is confirmed, medications are prescribed to improve blood flow and reduce arterial spasm. Physiotherapeutic treatment and balneotherapy are indicated. The doctor must convince the patient to quit smoking.
As the disease progresses, surgical intervention may be required: from gentle techniques to amputation (for gangrene).
Common mistakes when self-medicating!
Progression of the disease and development of complications of damage to the arteries of the lower extremities, up to the development of gangrene and amputation of the lower extremities.
What kind of specialist help might you need?
- Internist or general practitioner (family doctor)
- Vascular surgeon
- Endocrinologist
What can you do?
To prevent vascular diseases, we can recommend:
- Physical activity (running, walking, going to the fitness center, swimming)
- Regular visits to the bathhouse
- Taking medications that strengthen the walls of blood vessels and prevent the formation of blood clots, for example TRANSVEROL
From the article you will learn what intermittent claudication is. For what reasons, under what diseases does the syndrome occur and how does it manifest itself? Types of treatment, prognosis for pathology.
Article publication date: 06/19/2017
Article updated date: 05/29/2019
Intermittent claudication is an increasing pain syndrome in the legs that occurs during physical activity (walking, lifting, running) and goes away after a short rest. This type of pain occurs with a long-term, or chronic, form of impaired blood flow in the arterial vessels and, as a consequence, insufficient blood supply to the tissues.
The pathology can occur in any part of the leg or involve it entirely, but in most cases, patients are bothered by pain in the lower legs. Their intensity is so great that it is impossible to continue moving. In the early stages of pathology, rest brings relief and pain subsides. As the disease progresses, the pain syndrome is constant, and any load makes it unbearable.
During the pathological process, the lumen of the arteries narrows due to a number of reasons (described in the corresponding section of the article), blood flow in this area is difficult, and the tissues do not receive enough oxygen and nutrients. With any load, the need for adequate blood supply increases, but pathologically altered arteries do not fully perform their function. Oxygen starvation or tissue ischemia occurs, which manifests itself as an increasing pain syndrome.
The danger of this condition is that changes in the walls of the arteries are not only in the legs - all arterial trunks are affected, including the heart muscle and brain. More than 20% of people with established intermittent claudication syndrome die from coronary and cerebral circulatory disorders within the first 5 years, and 10% lose a leg and become disabled.
There is no complete cure for the disease, but timely conservative therapy or surgical treatment will help save from amputation and prolong life.
This pathology is treated by vascular or, in smaller medical institutions, general surgeons.
Causes of intermittent claudication
Pain in the legs when walking is a symptom of chronic arterial insufficiency, which occurs against the background of various vascular diseases. Their division by frequency of occurrence is presented in the table:
| Disease | Quantity in percentage |
|---|---|
| Atherosclerosis – deposition of cholesterol complexes in the vascular wall | 81,6 |
| Nonspecific aortoarteritis – inflammation of the wall of the arterial trunks against the background of changes in the activity of one’s own immunity | 9 |
| – secondary pathological changes in the walls of blood vessels against the background of high levels of glucose in the blood | 6 |
| Thromboangiitis obliterans - inflammation of all layers of the vessel wall with the formation of blood clots in the lumen and their replacement with connective tissue | 1,4 |
| Raynaud's disease is a chronic spasm or narrowing of small capillaries of the microvasculature, including vessels supplying large arterial and venous trunks | 1,4 |
Symptoms of Raynaud's disease Classification
In angiosurgery, the Fontaine-Pokrovsky classification of chronic disturbances of blood flow in arterial vessels is used:
| Stage | Characteristic |
|---|---|
| The first is intermittent, non-limiting intermittent claudication. | Increased sensitivity to cold Slightly impaired tactile sensitivity (“goosebumps”, “tingling”) Seizure episodes Slower growth of nails and hair |
| The second is a limiting (limiting) walking disorder | Second A – pain does not occur during normal walking of more than 200 meters Second B – pain in the legs bothers you at a distance of less than 200 meters |
| Third – pain syndrome without exercise | The initial stage is characterized by pain at night, which goes away when you lower your leg from the bed. Later, the pain syndrome is constant, the leg is swollen, pale with a bluish tint |
| Fourth – ulcerative-necrotic changes in leg tissue | The appearance of skin ulcerations The ulcers deepen, merge with each other, forming large areas of dead tissue |
When we say “pain-free distance,” we evaluate walking on level ground. When going up or along steps, blood flow disturbance appears earlier.
The medical term “chronic critical ischemia of the lower extremities” includes changes in vessels and tissues of stage 3–4 according to the classification, requires constant pain relief and is accompanied by a high risk of leg amputation.
Trophic ulcers on the leg Based on the level of damage to the arterial trunks, several types of intermittent claudication are distinguished:
Symptoms of pathology
Manifestations of chronic disorders of blood flow in the arterial vessels of the legs include a number of symptoms, the main one being intermittent claudication.
| Clinical manifestation | Its features |
|---|---|
| Pain syndrome | In the first stages, blood supply disturbances occur only during exercise, later - even at rest. The pain is sudden, goes away only after rest (unless there is a critical disturbance in blood flow with the development of tissue necrosis) |
| Paresthesia | Feeling of numbness in the leg or part of it Local decrease in skin temperature |
| Changes in the skin and its appendages | Increased moisture in the skin (hyperhidrosis) – with thromboangiitis Very dry skin with abundant areas of peeling, cracking and brittle nails - with atherosclerotic vascular lesions |
| Osteoporosis | Fragility of bone tissue due to increased calcium excretion |
| Alopecia | Areas of complete hair loss on the skin of the leg |
| Tissue atrophy | Destruction of muscle and fat cells due to impaired blood supply to tissues (symptoms of “empty heel” or “empty toe” - with local pressure, the impression remains for a long time) |
| Tissue death or gangrene | Occurs at stages 3–4 of impaired blood flow in an arterial vessel Dead or necrotic tissue cannot be restored and requires surgical removal |
Osteoporosis - like intermittent claudication - can be caused by chronic circulatory failure in the legs The quality of life of a patient with intermittent claudication depends on the level and stage of arterial vasoconstriction:
- the initial stages of the disease remain unnoticed, since moderate pain in the legs is not so pronounced and does not require rest during exercise;
- the pain syndrome, starting from the second stage of the process, is already quite intense, forcing you to change habits and the amount of one-time workload, making life and work less comfortable;
- extreme degrees of blood flow impairment are accompanied by constant pain, which does not allow even household chores to be performed; patients require outside help.
Symptom of intermittent claudication Diagnostics
| Method | What does it evaluate? |
|---|---|
| Questioning (complaints, anamnesis) | Presence of characteristic complaints. Duration of the disease. Features of pain to exclude other causes of pathology. |
| Inspection | Assessment of the pulse in the central and peripheral arteries: its strength, filling, presence. Assessing signs of changes in tissue nutrition (trophism): ulcerations, hair loss, fragility and layering of nails, swelling, bluishness of the skin. |
| Functional tests | Opel's test - raise the legs from a lying position by 40 cm, fix for 2 minutes, pronounced pallor and bluishness of the skin is noted on the affected side. Burdenko's test - quickly bend the leg at the knee 10 times; if blood flow is impaired, marbling of the skin is noted. Palchenkov's test - cross your legs in a sitting position for 5-10 minutes; if there is insufficient blood supply, pain and changes in skin color occur. |
| Ultrasonography (ultrasound Dopplerography) | Assessment of blood flow speed in vessels. Localization of the exact location and extent of the narrowing zone of the artery. Determining the cause of blood flow disturbances. Assessment of the presence of bypass blood supply to the area of interest. |
| Treadmill test | An assessment of the rate of restoration of normal blood flow in the legs after walking 200 meters is distinguished: limited reserve (recovery less than 15 minutes) and critical reserve (more than 15 minutes). Used to determine indications for surgical treatment. |
| Transcutaneous oximetry | Determination of the amount of oxygen in arterial blood and in the capillaries of the skin (shows the level of saturation of tissues and their ability to recover independently in conditions of trophic disorders). The norm is 50–60 mm. rt. Art., borderline numbers – 30–40. |
| Flowmetry (laser Dopplerography) | Assessment of the quality of capillary blood flow. |
| Angiography | Examination of arteries by introducing a special contrast material visible in X-rays. Accurate determination of the affected area. Assessment of the vascular wall throughout. Resolving the issue of the need and possibilities of surgical treatment. |
Angiography of blood vessels. The location of the narrowing of the vessel is indicated by an arrow. Treatment methods
Intermittent claudication is a condition that takes a lifetime to treat. There is no complete recovery, but with constant therapy, the risk of death is reduced, the quality of life and the ability to perform exercises improve.
General principles of treatment by stage
Conservative treatment
Indicated for patients with any stage of the process, it is carried out continuously, without interruption, until the end of life.
| Principle | Specific actions and/or medications |
|---|---|
| Eliminate risk factors | Quit smoking Normalize blood pressure and weight Compensate for sugar levels |
| Drink antiplatelet agents - make the blood less viscous | Aspirin |
| Taking statins improves fat metabolism | Lipobolide Lovastatin Lipostabil |
| Restore metabolic processes | Trental Vitamins Actovegin |
| Improve tissue oxygenation | Tocopherol |
| Drink prostaglandins - suppress inflammation in the vascular wall | Alprostan Vazaprostan |
| Boost immunity | Polyoxidonium T-activin |
| Non-drug treatment | Massage Physiotherapy Spa treatment Hydrogen sulfide baths |
Surgery
It consists of performing reconstructive operations aimed at restoring normal blood flow in the area with the pathological process.
Scheme of the stenting operation: A – catheter insertion; B – balloon inflation and stent installation; C – removal of the catheter from the lumen of the vessel. Forecast
Intermittent claudication is the main syndrome of chronic damage to the arterial system, and it is impossible to completely recover from the pathology. The established diagnosis is an indication for permanent, lifelong, conservative therapy, even if reconstructive vascular surgery has been performed.
Pathological changes in arterial vessels are twice as common in the male population.
After diagnosis, 20–30% of patients die within the first 5 years, and 40–70% within 10 years. More than 65% of them die from acute forms of blood flow disorders in the heart vessels or arteries of the brain, since any pathological changes in the vessel wall cannot be local in nature and affect only the legs.
Regarding the preservation of legs, the prognosis is more favorable: with constant treatment, vascular changes stabilize in 70–75%, and pain even decreases in 40–45%. In only 10–20% of patients, signs of blood flow disturbances increase and lead to amputation.
Intermittent claudication is a symptom complex caused by impaired blood supply to the lower extremities and manifests itself as transient pain in the legs that occurs while walking. The reasons are vascular diseases (endarteritis), infections, intoxication (for example, manganese), trauma, etc. Due to spasm of peripheral vessels, insufficient blood supply to the muscles and nerves of the lower extremities (rarely - the upper).
Patients first feel fatigue, paresthesia in the legs, then pain appears while walking; patients are forced to stop for a while, after which the pain disappears and patients can continue walking. Subsequently, the pain becomes more persistent. With intermittent claudication, the pulse in the foot disappears, less often in the popliteal fossa, the color of the skin changes (it turns pale, and in later periods, cyanosis appears). The temperature and sensitivity of the foot and toes decrease, the foot becomes cold, pain appears in the calf muscles and pain occurs when pressure is applied to the nerve trunks in the legs. Trophic ulcers may appear on the feet. The course of intermittent claudication is chronic with remissions.
Treatment of the underlying disease; prohibition of alcohol and smoking; Tightening the legs (with elastic socks, elastic stockings, etc.) and cooling are contraindicated. Prescribe pachycarpine 0.05-0.1 g 2 times a day for a month, after a break - a repeat course; nicotinic acid 0.025 g 3 times a day (after meals); diathermy, UHF, hydrogen sulfide, radon baths.
Intermittent claudication (claudicatio intermittens, claudicatio ischaemica) is a syndrome that occurs with ischemia of the lower extremities caused by circulatory disorders (most often obliterating endarteritis or arteriosclerosis) and is characterized by the appearance of pain or a feeling of tension, heaviness, paresthesia during walking in one or (less often) in both legs. If the patient stops, the pain goes away and returns when walking. The disease develops more often in elderly and middle-aged men, and is rare in young people. Familial cases of intermittent claudication have been described.
Etiology: acute (,) and chronic () infections, intoxication (alcohol, especially smoking), cooling, physical and mental trauma, diabetes, etc. Some of these points (infections, intoxication) are apparently complicated by the disease endocrine -vegetative apparatus.
Pathogenesis boils down to ischemic phenomena due to vasospasm. The latter is caused by dysfunction of the adrenal system of the adrenal glands (humoral theory), with which the sympathetic nervous system is morphophysiologically connected (neurogenic theory). This leads to insufficient blood supply to the nerves and muscles of the limbs, especially during their activity (walking), and damage to the nerve endings, which in turn increases vascular spasm. As a result of the pathological chain of all these factors, a dystrophic neurovascular process develops. The development of the disease is usually chronic, but an acute course is also described.
Symptoms of intermittent claudication
Peripheral [Charcot (J. Charcot)] and spinal [Dejerine (J. Dejerine)] types of intermittent claudication have been described. With intermittent claudication of the peripheral type, patients often feel fatigue, heaviness or paresthesia in the legs before pain appears when walking. An objective examination reveals a weakening or disappearance of the pulse in the foot, less often in the popliteal fossa, and in old cases in the femoral artery. When examining the skin temperature of the foot and toes, a periodic, then persistent decrease is revealed. Skin color changes. If the patient weighs the affected leg, a pale, bluish coloration of the skin of this leg appears and pain occurs. The symptom of a “white spot” is characteristic.
The pain gradually becomes more frequent and intensifies. Over time, trophic ulcers and hypotrophy of the lower leg muscles may appear. As dystrophic and proliferative processes develop in the vessels, a picture of obliterating endarteritis may develop. During this period, arteriography sometimes reveals changes in the vascular walls and narrowing of their lumen. There is a phased nature of the course of intermittent claudication. The spinal form of intermittent claudication usually appears in the prodromal period of chronic processes (myelitis, syphilis) with damage to the arterioles that supply the gray matter of the spinal cord.
Diagnosis of intermittent claudication
Diagnosis of intermittent claudication is usually not difficult, taking into account the typical occurrence of pain in the legs when walking, their cessation when stopping, weakening or disappearance of the pulse of the main arteries of the leg, as well as subjective and objective temperature disturbances. Sometimes intermittent claudication must be differentiated from polymyositis, sciatica, flat feet, and Raynaud's disease. The prognosis is unfavorable in cases of obliteration of the vessels of the limb, however, there may be remissions during the course of the disease.
Treatment of intermittent claudication
Smoking and drinking alcohol should be prohibited. You should not wear tight shoes, you should avoid humidity, cooling your feet, and pulling your feet with rubber. Intravenous injection is recommended 5-10% NaCl solution 10 ml 10-15 infusions, subcutaneous 1% pilocarpine solution, insulin 10-12 units (No. 10), padutin, preferably depot-padutin (No. 15-20) 1 ampoule intramuscularly, through Repeat 2-4 weeks, 1% solution of nicotinic acid orally, 1 table. l. for a month or intravenously 1% -1 ml (No. 10-15), repeat courses; pachycarpine 0.1 g 3 times a day for 2 months, repeat periodically.
Perirenal novocaine blockade gives favorable results. Sometimes intra-arterial injection of canned blood into the vessels of the affected limb is successfully used. Physiotherapeutic methods include diathermy, UHF, mud therapy, steam pressure chamber, hydrogen sulfide and radon baths, 2-3 courses each, alternating. For syphilis and atherosclerosis - appropriate treatment and diet. Among the surgical methods proposed are periarterial sympathectomy (see), epinephrectomy; in the gangrenous phase - amputation.
Intermittent claudication occurs as a result of the development of occlusive-stenotic processes in the arterial vessels of the legs. Patients complain of pain in the legs, fatigue, weakness, and cramps in the calf muscles. All symptoms worsen with physical activity.
The patient walks about 100 meters, after which he develops the symptoms described above. In order for the discomfort to go away, you need to stop and sit or stand for a while. After such a rest, a person resumes his journey and after the same distance he needs rest.
Intermittent claudication is part of a complex of symptoms that indicate damage to the vessels of the lower extremities.
Classification of lower extremity ischemia
This condition is divided into 4 degrees:
- The patient has damage to the arterial vessels of the lower extremities, but there is still no discomfort or pain when walking a distance of 1 km;
- This degree is divided into degrees 2a and 2b, which differ from each other only in the walking distance. With degree 2a, the distance varies from 200 meters to 1 km, and with degree 2b - less than 200 meters;
- Grades 3 and 4 are combined with the term “critical ischemia” and are stages of the disease in which, without proper and timely treatment, the patient loses his leg. At grade 3, pain in the legs is constant, pain relief is necessary;
- This is the final stage of the disease, in which trophic changes in the soft tissues of the legs occur and gangrene develops.
This type of classification is necessary to select adequate therapy. The above classification allows you to choose treatment.
Features of treatment for different degrees of ischemia
The first degree of ischemia does not require specific treatment. In this situation, it is necessary to adjust the impact of risk factors.
In the second degree of ischemia, which is accompanied by intermittent claudication, medications are prescribed to increase walking distance. Correction of risk factors certainly remains. The patient must also engage in training walking. If conservative treatment does not help and the pain-free walking distance is sharply reduced, surgical treatment is used, since only this type of therapy can increase blood flow in the limb.
Various angioplasty manipulations with the use of stents, as well as without them, can be used as surgical procedures. This type of treatment is basic, or initial. If it is impossible to perform angioplasty surgery, bypass surgery is used to improve blood circulation in the limb.
Directions in the treatment of patients with conditions such as intermittent claudication
Correction of risk factors
Each patient who has been diagnosed with arterial disease of the extremities must change their lifestyle in order for further treatment to be as effective as possible:
- to give up smoking;
- normalization of blood glucose levels;
- normalization of blood pressure.
Thus, the patient should consult a therapist or cardiologist.
Correction of elevated blood lipid levels
If the patient develops intermittent claudication, they must necessarily receive medications that reduce the level of fats in the blood. When using such therapy, the risk of developing not only cardiovascular diseases decreases, but also the distance of pain-free walking increases. According to authoritative studies, when using simvastatin, pain-free walking distance increased by an average of 120% compared to patients in the placebo group. Atorvastatin also increased the distance, but by 22%. The maximum walking distance increases by 164 meters.
Treatment with antiplatelet drugs
Antiplatelet agents are needed by patients with intermittent claudication as much as they are needed by patients with. These medications, when taken for a long time, have the ability to reduce the risk of blood vessels and also increase walking distance. Antiplatelet drugs in another study increased walking distance by 60 m. In Russia, the antiplatelet drug ticlopidine, which was used in the study, is used. Its effectiveness is a 40% increase in maximum walking distance.
Training walking
The evidence base of this technique is the most complete and realistic. The effectiveness of training walking for intermittent claudication has been proven and confirmed. Studies have been conducted where, under the guidance of instructors, patients were offered exercises to train their legs. After some time, the patients themselves noted a decrease in pain and an increase in endurance during physical activity.
A patient with intermittent claudication must walk for half an hour a day.
Drugs to increase pain-free walking distance
The remaining medications present on the Russian market for the treatment of intermittent claudication do not have any evidence base.
Summarizing
- Ischemia of the lower extremities is characterized by a decrease in blood flow in the arterial vessels;
- Patients with intermittent claudication are currently treated conservatively;
- Treatment of the disease should begin with the correction of risk factors;
- Among medications, it is worth taking antilipid and antiplatelet drugs;
- Pentoxifylline is also used for therapy, the effectiveness of which has a high evidence base. In Russia, you can use the long-acting drug Vazonit.
Intermittent claudication is not a disease in a broad sense, but rather a symptom of certain diseases. It arises as a result of certain pathological conditions in the human body and requires mandatory attention to itself.
The disease is a consequence of malfunctions of the neuromuscular system or disturbances in the blood circulation of the lower extremities. This symptom can significantly ruin the life of its owner. Intermittent claudication syndrome, its second name is Charcot's syndrome, is characterized by the occurrence of discomfort and pain in the lower leg when walking at a distance of 200-1000 m. The intermittent symptom is that this pain goes away after a short rest and the patient can continue to move. However, the pain quickly returns, forcing the person to limp.
Types of disease
Based on research into the causes of this disease, it was concluded that there are two types of this disease:
- Caudogenic, also known as neurogenic. It occurs due to a narrowing of the spinal canal in the lumbar region, which can be congenital or acquired. The cause of acquired narrowing is spondylopathies and osteochondrosis. The resulting changes disrupt the transmission of nerve impulses to the lower extremities and their correct return to the central nervous system.
- Vascular, is true and occurs due to atherosclerotic damage to the vessels of the lower extremities. The narrowing of the arterial lumen disrupts blood circulation in the tissues and oxygen supply to the muscles, causing ischemia.
Signs of the disease, both neurogenic (caudogenic) and vascular, include pain and discomfort when walking. The differences lie in the fact that lameness of vascular origin is accompanied by pain, and lameness of nervous origin is accompanied by paresthesia and a feeling of crawling throughout the body. Such paresthesias can spread to both legs and reach the inguinal fold.
To determine the degree of severity and treatment tactics, the clinical classification according to Pokrovsky was adopted, which distinguishes 4 of its varieties:
- The 1st degree is characterized by the fact that the patient already has disturbances in the blood supply to the lower extremities, but does not yet feel pain when walking. The main symptom is discomfort that occurs when walking over distances of more than 1000 m or when climbing stairs. At this stage, few people see a doctor, so the changes often progress.
- For convenience, the 2nd degree is divided into two more types. 2A - the walking distance without severe pain is 200 - 1000 m. 2B degree - the patient is able to overcome a distance of up to 200 m without pain. At the second stage, drug intervention can still be effective.
- Stage 3, called critical ischemia, is accompanied by pain in the legs, which does not disappear even at rest. The skin changes color, symptoms of blood stagnation are obvious. Urgent surgery can still save the limb or part of it.
- The 4th degree is characterized by irreversible changes in blood vessels and muscles, the development of trophic ulcers or even gangrene. The limb is usually amputated. If this is not done, the patient may die from septic complications.
Diagnostic algorithm
Pathology is detected using a variety of tests aimed at measuring the distance that the patient is able to overcome painlessly. If this syndrome is confirmed, then the next step is to find the cause of its occurrence. The main method for determining the width of the arterial lumen is ultrasound of the vessels of the limb with Doppler. It allows you to identify the extent of atherosclerotic lesions or the location of individual plaques.
Angiography is the main method of studying blood vessels, the essence of which is to introduce a contrast agent into the vascular bed and monitor its “journey” through the arteries using a special X-ray unit. Allows you to reliably verify the location and size of the obliterated section of the artery.
What should be the treatment and prevention?
An effective medicine used in the initial stages of the disease is training walking. Moreover, doctors advise practicing this sport with special instructors, since doing it on your own is often incorrect and does not have the desired positive effect.
At the second stage of pathology, manipulations to modulate risk factors are also effective. Thus, treatment consists of treating systemic atherosclerosis. Main groups of drugs:
- Disaggregants and anticoagulants for the prevention of thrombosis.
- Lipid-lowering drugs to reduce total cholesterol levels in the blood.
- There are studies confirming that the use of pentoxifylline at the maximum dose (1200 mg) can alleviate symptoms and improve peripheral circulation, which promotes the formation of collaterals.
- Severe pain in the legs can be treated occasionally with non-steroidal anti-inflammatory drugs. After a long walk, adequate rest is necessary.
At the third stage, to treat the disease, surgical intervention is most often required, the purpose of which is to optimize the arterial blood flow of the ischemic area. All kinds of bypass surgery and stenting of narrowed areas are performed in the hope of saving the patient’s limb. However, such assistance measures may be ineffective.
The fourth stage is the sad ending. The changes are not reversible, and amputation of a limb often provokes large blood losses and infection, since the amputation site heals very poorly due to widespread systemic atherosclerosis.
Prevention of this disease is all measures that are used to prevent systemic atherosclerosis. Victory over bad habits, proper nutrition, and active pastime can not only help restore the body, but also prevent the emergence and development of diseases. Preventive measures are especially necessary for patients at risk. These include older people, hypertensive patients, diabetics, smokers, overweight people, and people with metabolic disorders.
Intermittent claudication, which is challenging to treat, is potentially disabling in the young population. Taking care of yourself and following the rules of a healthy lifestyle can prevent most diseases.
