Claudication is pain caused by too little blood flow to muscles during exercise. Most often this pain occurs in the legs after walking at a certain pace and for a certain amount of time -- depending on the severity of the condition.
The condition is also called intermittent claudication because the pain usually isn't constant. It begins during exercise and ends with rest. As claudication worsens, however, the pain may occur during rest.
Claudication is technically a symptom of disease, most often peripheral artery disease, a narrowing of arteries in the limbs that restricts blood flow.
Treatments focus on lowering the risks of vascular disease, reducing pain, increasing mobility and preventing damage to tissues.
Claudication refers to muscle pain due to lack of oxygen that's triggered by activity and relieved by rest. Symptoms include the following:
The pain may become more severe over time. You may even start to have pain at rest.
Signs or symptoms of peripheral artery disease, usually in more-advanced stages, include:
Talk to your doctor if you have pain in your legs or arms when you exercise. Claudication can lead to a cycle that results in worsening cardiovascular health. Pain may make exercise intolerable, and a lack of exercise results in poorer health.
Peripheral artery disease is a sign of poor cardiovascular health and an increased risk of heart attack and stroke.
Other conditions involving the blood, nerves, and bones can contribute to leg and arm pain during exercise. It's important to have a complete exam and appropriate tests to diagnose potential causes of pain.
Claudication is most often a symptom of peripheral artery disease. The peripheral arteries are the large vessels that deliver blood to the network of vessels in your legs and arms.
Peripheral artery disease is damage to an artery that restricts the flow of blood in an arm or leg (a limb). When you're at rest, the limited blood flow is generally still enough. When you're active, however, the muscles aren't getting enough oxygen and nutrients to work well and remain healthy.
Damage to peripheral arteries is usually caused by atherosclerosis. This is the buildup of cholesterol and other fats, blood cells, and other cellular debris into abnormal structures (plaques) on the lining of an artery
.Plaques cause a narrowing and stiffening of the artery, limiting the flow of blood. If the plaques rupture, a blood clot can form, further reducing blood flow.
The risk factors for peripheral artery disease and claudication include the following:
Claudication is generally considered a warning of significant atherosclerosis in the circulatory system, indicating an increased risk of heart attack or stroke. Additional complications of peripheral artery disease due to atherosclerosis include:
The best way to prevent claudication is to maintain a healthy lifestyle and control certain medical conditions. That means:
Angioplasty (AN-jee-o-plas-tee) is a procedure used to open clogged heart arteries. Angioplasty uses a tiny balloon catheter that is inserted in a blocked blood vessel to help widen it and improve blood flow to your heart.
Angioplasty is often combined with the placement of a small wire mesh tube called a stent. The stent helps prop the artery open, decreasing its chance of narrowing again. Most stents are coated with medication to help keep your artery open (drug-eluting stents). Rarely, bare-metal stents may be used.
Angioplasty can improve symptoms of blocked arteries, such as leg pain and poorly healing ulcers.
Angioplasty is used to treat the buildup of fatty plaques in your blood vessels. This buildup is a type of vascular disease known as atherosclerosis.
Angioplasty may be a treatment option for you if:
Angioplasty isn't for everyone. Depending on the extent of your leg disease and your overall health, your doctor may determine that bypass surgery is a better option than angioplasty for you.
Although angioplasty is a less invasive way to open clogged arteries than bypass surgery is, the procedure still carries some risks.
The most common angioplasty risks include:
Angioplasty is performed by a specialist and a team of specialized cardiovascular nurses and technicians in a special operating room called an angiography suite.
Angioplasty is performed through an artery in your groin, arm, wrist or ankle area. General anesthesia isn't needed. You'll receive a sedative to help you relax, but you may be awake during the procedure depending on how deeply you are sedated.
Angioplasty can take up to several hours, depending on the difficulty and number of blockages and whether any complications arise.
You might feel pressure in the area where the catheter is inserted. You may also feel some mild discomfort when the balloon is inflated and your artery is stretched, but typically you shouldn't feel any sharp pain during the procedure.
Most people who have an angioplasty also have a stent placed in their blocked artery during the same procedure. A stent, which looks like a tiny coil of wire mesh, supports the walls of your artery and helps prevent it from re-narrowing after the angioplasty.
Here's what happens during a stent placement:
Stents implanted during an angioplasty are often drug coated. The medication in the stent is slowly released to help prevent future plaque buildup and the re-narrowing of the blood vessel.
After your stent placement, your doctor will prescribe medications, such as aspirin, clopidogrel (Plavix), ticagrelor (Brilinta) or prasugrel (Effient), to reduce the chance of blood clots forming on the stent.
You generally should be able to return to work or your normal routine the week after angioplasty.
When you return home, drink plenty of fluids to help flush your body of the contrast dye. Avoid strenuous exercise and lifting heavy objects for at least a day afterward. Ask your doctor or nurse about other restrictions in activity.
Call your doctor's office or hospital staff immediately if:
It's important that you closely follow your doctor's recommendations about your treatment with blood-thinning medications -- aspirin and clopidogrel (Plavix), prasugrel (Effient) or similar medications.
Most people who have undergone angioplasty with or without stent placement will need to take aspirin indefinitely. Those who have had stent placement will need a blood-thinning medication, such as clopidogrel, for six months to a year. If you have any questions or if you need any other type of surgery, talk to your interventional radiologist before stopping any of these medications.
Angioplasty greatly increases blood flow through the previously narrowed or blocked artery. Your leg pain generally should decrease, and you may be better able to exercise.
Having angioplasty and stenting doesn't mean your vascular disease goes away. You'll need to continue healthy lifestyle habits and take medications as prescribed by your doctor.
To keep your heart healthy after angioplasty, you should:
Successful angioplasty also means you might not have to undergo bypass surgery, a more invasive procedure that requires longer recovery time.
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