The prognosis of intermittent claudication

The purpose of this study is to obtain the informations about the fate of the limbs and lives of claudicants due to arteriosclerosis obliterans. Two hundred and seven lower limbs of 165 patients suffering from intermittent claudication were observed for an average period of about six years. Eighty-seven limbs of 69 patients were managed nonsurgically (Group A). Ninety-eight percent of limbs in Group A remained unchanged or improved, and no limb was amputated. One hundred and twenty limbs of 96 patients had arterial reconstructions (Group B). Although 75 percent of limbs in Group B had benefits by successful operations, 26 percent of them experienced graft failures, and 2.7 percent of them were amputated. Five year graft patency rates in the limbs with supra- and infra-inguinal reconstructions were 82.1 percent and 65.7 percent, respectively. Operative mortality rate was 2.1 percent, and mortality rate due to late complications was 3.3 percent. The prognosis of intermittent claudication with regular follow-up was relatively good, therefore, it is important to recognize that arterial reconstruction is not the only way to treat limbs with mild intermittent claudication. About 30 percent of claudicants died within 5 years, and 60 percent of them died from cardiac or cerebrovascular disease. The results suggested that much attention should be paid to the lives as well as the limbs of claudicants.