Management
Each Intermittent Claudication patient needs his or her own optimal management plan, aimed at reducing symptoms, improving quality of life and decreasing overall cardiovascular risk.
Importantly, patients should follow an exercise programme and stop smoking. For patients who do not respond to these lifestyle measures, medical intervention may be needed, including pharmacological treatment and, in some cases, surgery.
Lifestyle measures:
Studies have shown Intermittent Claudication patients may benefit from lifestyle measures such as starting an exercise programme and stopping smoking.
Exercise
For maximum benefit patients should walk between 30 and 60 minutes a day, attempting to walk through the pain as far as possible. When they cannot continue, they must rest until the pain subsides and then walk again.
However, exercise programmes may not be suitable or convenient for all patients, and many are discouraged by having to endure a certain amount of pain. In addition, although exercise programmes often improve walking distance, they rarely diminish the symptoms of intermittent claudication altogether.
Smoking
Heavy smoking doubles the risk of Intermittent Claudication.
Stopping smoking may not improve Intermittent Claudication symptoms in all patients, but it does improve cardiovascular health and other complications.
Treatment specifically for Intermittent Claudication symptoms:
Not all patients are able to benefit from lifestyle changes and for these people pharmacological treatment may be required.
Pharmacological treatments to reduce overall cardiovascular risk
The reduction of overall cardiovascular risk is an important goal in the management of Intermittent Claudication. This may help to avoid progression to acute or chronic lower limb ischaemia and reduce the need for surgery or amputation. Key strategies, in addition to smoking cessation, include management of high cholesterol levels and use of antiplatelet agents, together with intensive management of diabetes and high blood pressure where required.
Surgery
For patients in whom lifestyle measures and pharmacological management prove inadequate to control symptoms and improve quality of life, angioplasty or surgery may be considered.
However, while these procedures can improve quality of life for suitable patients with Intermittent Claudication, and may help to prevent amputations, they make little difference to overall life expectancy.
