Claudication

Risk factors for claudication and other symptoms of peripheral artery disease (PAD) caused by atherosclerosis are:

• Smoking or a history of smoking
• High cholesterol levels
• High blood pressure
• Obesity
• Family history of vascular or heart disease

Your vascular surgeon will try to determine if you have claudication and peripheral artery disease and then recommend the best treatment for you. Your evaluation will include questions about your symptoms, their location and how often and for how long they have occurred. You'll also discuss your general health.

Your consultation will include a physical examination, including pulse tests. Your vascular surgeon will feel your pulse at various locations and may listen to it with an instrument called a doppler. Because atherosclerosis can affect any artery in your body, your vascular surgeon will usually check arteries in other parts of your body in addition to your legs.

Your physician may request other tests in order to make a diagnosis. These may include:

• Ankle brachial index (ABI)
• Pulse volume recording, which measures the volume of blood at various points in your legs
• Duplex ultrasound
• Blood tests for cholesterol, high blood sugar or other markers for artery disease
• Magnetic resonance angiography (MRA)>
• Computerized tomographic angiography (CTA)
• Angiography

A consultation with a vascular specialist can is recommended to discuss the severity of the disease and the various treatment options available. Based on the result of your physical exam and your diagnostic testing, your vascular surgeon will treat your claudication.

A major goal is to address the underlying cause of your PAD, the atherosclerosis. Lifestyle modifications may be recommended, including:

• Smoking cessation (this is the most important lifestyle modification)
• Weight loss
• Better nutrition
• Medication such as cholesterol-lowering drugs

Treatment for claudication usually begins with a daily walking exercise program and occasionally the use of specific medications prescribed as appropriate by your vascular surgeon.

Many patients' health levels improve markedly with a walking program and lifestyle changes, especially quitting smoking. Often these changes are all that is needed to improve symptoms of claudication. However, if they do not help or if the symptoms worsen, your vascular surgeon may recommend other medications, endovascular intervention or bypass surgery.