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What is claudication?

Intermittent claudication describes the symptom of pain in muscles brought on by exercise and relieved by rest. Usually the muscles affected are those in the calves or buttocks. The muscles need a steady blood supply during activity to prevent them from cramping or tiring easily. If arteries supplying these muscles are narrowed or blocked then the blood supply will be inadequate. Narrowing or blockage of arteries is often caused by atherosclerosis, a disease which is linked to smoking, high blood presssure, diabetes, obesity and lack of exercise. Patients with claudication are at increased isk of suffering angina and heart attacks.

What can be done to improve my symptoms?

In most cases smoking cessation, weight loss, appropriate control of blood pressure, cholesterol and diabetes are necessary. Aspirin (or another similar medicine) is essential; cholesterol lowering tablets (statins) and antihypertensives are often indicated. Walking distance can be improved with a combination of the above measures and a supervised exercise programme. This is often referred to as 'conservative therapy'. It is uncommon for claudication to progress to gangrene or ulceration if conservative therapy is followed closely.

Should I have an angioplasty?

Angioplasty is an invasive technique in which a fine catheter is inserted into the arteries and through a narrowed or blocked segment. A balloon on the end of the catheter can be inflated to open up the segment and so increase the flow of blood to the leg muscles. The technique may be highly successful in treating short blockages in large arteries. Angioplasty of longer blockages or small arteries may not have such good results. Angioplasty is a 'quick fix' but does not result in a permanent improvement. Indeed similar improvements can be achieved over a longer term with conservative therapy.

Will I need an operation?

If the degree of claudication is bad enough and the extent of disease makes angioplasty impossible, surgical bypass may be indicated. Surgery on arteries carries significant risks; if the bypass blocks off the circulation may be so bad as to necessitate an amputation. Therefore surgery is usuallyconsidered as a last resort.

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