Endovascular treatment of intermittent claudication

What is intermittent claudication?

Intermittent claudication – This is a condition in which there is a decrease in blood supply to the leg during exercise. It occurs due to disease in the arteries supplying the limb, resulting in obstruction or occlusion of the blood vessels. As a result, during physical activity, such as walking, pain or cramps appear in the legs, and then there is a need to stop and rest. The pain begins in the calf muscles and can spread to the gluteal muscles. Once the effort ceases or stops, the pain or cramping stops. Therefore, such lameness is intermittent. You may also experience a pins and needles sensation and decreased sensation in the leg.

What tests are done to evaluate intermittent claudication?

Before complications arise, it is recommended to evaluate for peripheral arterial disease (PAD) by checking the pulse of the arteries in the legs and comparing the blood pressure in the legs and arms. Using ultrasound (Doppler ultrasound), you can evaluate the speed of blood flow in the arteries of the lower extremities. If peripheral artery disease is suspected, visualization of the arteries using computed tomography or magnetic resonance angiography (CTA or MRA) may be needed to determine which arteries are blocked and to help plan treatment options.

What is endovascular treatment for intermittent claudication?

Endovascular treatment (catheterization) opens blocked blood vessels and improves blood flow to the leg. The treatment is a minimally invasive procedure, meaning it does not involve surgery. The procedure is performed by an invasive radiologist under visual control.

The patient lies on an operating table and is connected to screens that monitor his pulse, blood pressure and blood oxygen levels. The surgery is performed by an invasive radiologist who uses local anesthesia to numb the access site, usually in the groin area. Mild sedatives may also be used. Then the doctor creates an access through which he inserts a thin tube (catheter) into the artery and delivers it to the treatment site. A small amount of contrast agent is injected so that the invasive radiologist can clearly see the affected arteries.

This technique is used to treat obstruction or occlusion of blood vessels in the pelvis, thighs, and legs. Dilation or opening of the blood vessels is done by inflating balloons and sometimes by placing a stent at the site of an obstructed or occluded artery. At the end of the operation, there are no visible stitches on the skin. The tiny access window created on the skin is closed with a patch. This procedure is usually completed in less than two hours.

How is recovery after endovascular treatment?

After the procedure, you are prohibited from bending your leg for several hours and getting out of bed for about six hours. You may be discharged home the very next day, and after a few days you can return to work.