Intermittent claudication – the meaning of pharmacological and non-pharmacological therapy in chronic treatment Review article
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Abstract
Intermittent claudication is a typical sign of peripheral vascular disease, which results from limited arterial blood flow due to atherosclerosis, appears during exercises and is relieved after a short break. Intermittent claudication often presents as a pain in the calf muscle after walking a particular distance. Physical examination, detailed interview and ankle–brachial index are key elements of the diagnostic process, which allows for diagnosis of peripheral artery disease. The treatment is dependent on multiple factors, including the dynamics of the disease and coexisting diseases. The aim of the treatment of patients with intermittent claudication is reducing the risk of cardiovascular complications and improving the quality of life. The treatment is based on a conservative therapy, especially march training. The pharmacological treatment is limited to a few medications, which are rarely used. In the advanced stage of the disease the most appropriate option seems surgery.
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References
2. Hamburg NM, Creager MA. Pathophysiology of Intermittent Claudication in Peripheral Artery Disease. Circ J. 2017; 81: 281-9.
3. Criqui MH, Aboyans V. Epidemiology of peripheral artery disease. Circ Res. 2015; 116: 1509-26.
4. ACC/AHA Versus ESC Guidelines for Diagnosis and Management of Peripheral Artery Disease: JACC Guideline Comparison. J Am Coll Cardiol. 2018; 72: 2789-801.
5. Aboyans V, Ricco JB, Bartelink ML et al. [2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS)]. Kardiol Pol. 2017; 75: 1060-5.
6. McDermott MM, Ades P, Guralnik JM et al. Treadmill exercise and resistance training in patients with peripheral arterial disease with and without intermittent claudication: a randomized controlled trial. JAMA. 2009; 301(2): 165-74.
7. McDermott MM. Exercise training for intermittent claudication. J Vasc Surg. 2017; 66(5): 1612-20.
8. Jansen SC, Abaraogu UO, Lauret GJ et al. Modes of exercise training for intermittent claudication. Cochrane Database Syst Rev. 2020; 8: CD009638.
9. Gerhard-Herman MD, Gornik HL, Barrett C et al. 2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2017; 135: e686-e725.
10. Broderick C, Forster R, Abdel-Hadi M et al. Pentoxifylline for intermittent claudication. Cochrane Database Syst Rev. 2020; 10(10): CD005262.
11. Society for Vascular Surgery Lower Extremity Guidelines Writing Group; Conte MS, Pomposelli FB, Clair D G et al. Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: management of asymptomatic disease and claudication. J Vasc Surg. 2015; 61(3 suppl): 2S-41S.