Relevance of claudication pain distance in patients with peripheral arterial occlusive disease

Determination of both the pain-free and the maximum walking distances is part of a routine program in the angiological examination of patients with PAOD. It is however as yet not clear which of these two parameters is more relevant in determining a patient's pathological condition.

In 150 patients with stable intermittent claudication, the claudication pain distance (CPD) and the maximum pain distance (MPD) were determined on a treadmill at 3.0 km/h and 12% inclination. The results were compared with the angiographic findings, the Doppler pressure values and the subjective quality of life (PAVK-86-Questionnaire).

The average pain-free walking distance was 89 +/- 71 m, and the maximum walking distance was 198 +/- 141 m. There was no correlation between both walking distances and the angiographic extent of PAOD. Only the MPD correlated with the ankle systolic Doppler pressure and the ankle/brachial pressure index of the claudicating leg (r = 0.16, p < 0.05 and r = 0.20, p < 0.01). Both the CPD and the MDP had a significant influence on the life quality of the patients (CPD: r = -0.41, p < 0.001; MPD: r = -0.47, p < 0.001). In the multiple regression analysis, beside the body mass index, the MPD was found to be the greatest predictor for the pathologically relevant quality of life dimensions pain, complaints and functional status.

The maximum walking distance correlated in a better way than pain-free walking distance with the objective and subjective assessment criteria of PAOD. Therefore, as regards the stage of the disease and the life quality of the patient, this parameter has a greater importance. This fact deserves to receive greater attention in everyday clinical practice and when conducting clinical trials.