Claudication is discomfort in the calf, thigh or buttocks that occurs when walking or exercising. As much as 10 percent of the U.S. population has occasional claudication, which is also known as peripheral vascular disease. Claudication occurs when an artery in your legs or your aorta (the largest artery in the body) is narrowed or blocked by atherosclerosis, which decreases blood flow to your leg muscles.
Caring for claudication is one of many offerings for vascular care at Ohio State.
Claudication causes
The most common cause of blockage of arteries is atherosclerosis, a buildup of plaque (fatty substances, cholesterol, calcium and fibrin in the inner lining of an artery). Blockages in the leg are most common in the thigh and behind the knee. Risk factors for claudication and atherosclerosis include smoking cigarettes and tobacco use, diabetes, age greater than 70, high cholesterol and high blood pressure.
Claudication symptoms
Symptoms include pain with exertion, muscle cramping or weakness and a burning feeling or tired sensation in the lower extremities. Claudication is an indicator of systemic atherosclerosis and increases an individual’s risk of heart attack by three to four times. Other symptoms you may have include shiny, hairless, cold and ulcerated skin. When you develop a severe lack of blood flow in your limb, you may have pain in your foot during rest. If you’re a man, you may also have impotence.
Diagnosis
Claudication can indicate you have underlying systemic atherosclerosis and a significantly increased risk for heart attack and stroke. Because of this, your symptoms of claudication should be assessed. If you are diagnosed with claudication, you should be screened for coronary and carotid artery disease.
Tests to check for claudication include:
- Ankle-brachial index (ABI) – A test that measures blood pressure in the effected extremity
- Ultrasound – A test that uses high-frequency sound waves to evaluate blood flow in a vessel
- Angiogram – An X-ray of blood vessels to identify blockage; it is performed by inserting a tube into an arte
Claudication treatment
Treatment of claudication focuses on modifying your risk factors, including:
- Stopping tobacco use
- Beginning an exercise program
- Eating a diet low in saturated fats
- Treating medical problems – high cholesterol, high blood pressure, high blood sugar levels – with diet, exercise or medication
- Preventing heart attack and stroke with antiplatelet medication
- Taking medication such as cilostazol to improve walking tolerance
Many of these risk factors can be reduced or eliminated by changing your lifestyle.
If your case is advanced and you have severe pain or almost completely blocked blood flow, you may require more invasive treatment, such as:
- Angioplasty
- Stent placement
- Vascular surgery or, in extreme cases, coronary artery bypass graft (CABG) surgery
In a small number of cases, when progression of the condition is not halted, amputation of the affected limb may be necessary.
Studies are underway in the Division of Vascular Diseases and Surgery at The Ohio State University Wexner Medical Center to evaluate the use of a patient’s own stem cells to treat severe blockage when all other treatments are exhausted and the only alternative is amputation.
