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Natural history of intermittent claudication in the Japanese
Insights
The natural history of intermittent claudication (IC) shows favorable outcomes for arterial occlusions but worsening for arterial stenoses. Careful follow-up and risk factor control are crucial for stenosis cases.
Area of Science:
- Vascular Surgery
- Cardiovascular Medicine
Background:
- Intermittent claudication (IC) is a common manifestation of peripheral artery disease.
- Understanding the natural history of IC is vital for patient management and treatment strategies.
Purpose of the Study:
- To investigate the natural history of intermittent claudication based on different arterial lesion types.
- To determine the prognosis of IC related to iliac and femoropopliteal arterial stenosis versus occlusion.
Main Methods:
- A survey of 59 limbs in 44 patients with intermittent claudication.
- A mean follow-up period of 3 years (range: 1 to 8.3 years).
- Analysis of outcomes based on solitary vs. multiple arterial lesions, and stenosis vs. occlusion.
Main Results:
- 72% of limbs with solitary arterial lesions improved or remained unchanged.
- Limbs with iliac artery stenosis (53.3%) and femoropopliteal artery stenosis (50%) showed worsening.
- Limbs with iliac artery occlusion (18.7%) and femoropopliteal artery occlusion (0%) had less worsening.
Conclusions:
- Intermittent claudication due to solitary arterial stenosis tends to worsen.
- Intermittent claudication due to solitary arterial occlusion generally improves or remains stable.
- Stricter follow-up and risk factor management are essential for patients with arterial stenosis.
Abstract:
The natural history of intermittent claudication (IC) was surveyed in 59 limbs of 44 patients. The mean follow-up period was 3 years (1 to 8.3 years). During the follow-up period, 72.0 per cent of the limbs with a solitary arterial lesion improved or remained unchanged. However, detailed analysis showed that 53.3 per cent of limbs with iliac artery stenosis and 50.0 per cent of those with femoropopliteal artery stenosis worsened, whereas only 18.7 per cent of limbs with iliac artery occlusion and no limbs with femoropopliteal artery occlusion had worsening of symptoms. Of limbs with multiple arterial lesions, 62.5 per cent worsened. Although the natural history of IC is relatively favorable, IC due to a solitary arterial stenosis tends to worsen, whereas IC due to a solitary arterial occlusion will, in more than 80 per cent of cases, improve or remain unchanged. In cases of arterial stenosis, therefore, more careful follow-up, including control of risk factors, is mandatory.