Claudication

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The most comprehensive national approach to improving claudication.

Claudication is defined as the fatigue, discomfort, numb sensation, cramping or pain that occurs in leg muscles (not joints) during exercise, that resolves with rest, and that is determined to be due to PAD’s impact on lowering leg blood flow. Claudication worsens quality of life and independence. It may negatively impact home, work, or family life.

There are at least four different strategies that are proven to help patients with PAD and claudication improve. In the United States, few patients with PAD are fully informed about each option and most never learn what is possible. The Vascular Medicine Program assures each patient that all options are realistically considered and prescribed. Once prescribed, individual responses are monitored. Fully informed patient choice is key to long-term success.

Medical Therapy for Risk Reduction

Medical Therapy for Risk Reduction

Medications are used to reduce the risk of heart attack or stroke. These are very important consideration for every patient with PAD, regardless of the severity or absence of leg symptoms. Each patient will know their own treatment goals as a plan is emplaced to control blood pressure, cholesterol and diabetes, and to prevent heart and brain blood clots.

Smoking Cessation

Smoking Cessation

Our program designed and completed the first ever clinical trial designed to help patients with PAD stop smoking. Tobacco cessation, quickly and permanently, is a key goal for those patients who are ready to quit. Our team will work with your primary care clinician to assure that smoking cessation behavioral and medication therapies are offered and used.

PAD Supervised Exercise Rehabilitation (“PAD rehab”)

PAD Supervised Exercise Rehabilitation (“PAD rehab”)

It is known, and not controversial, that the single most powerful method to improve claudication is the prescription of a three month program of treadmill-based exercise training provided by skilled exercise physiology specialists within a supervised (safe) setting. As national leaders in the design, evaluation, and community dissemination of this approach, we provide regional and national leadership in this technique. The benefits of an exercise approach are lifelong, and can be enjoyed by almost any patient. Five M Health sites are available for your convenience and we work with other health systems to promote this approach.

For more info:
PAD Rehab Program
WEL Program

Claudication Medication

Claudication Medication

For patients with claudication, as for angina or back pain, it would be a dream if a medication could improve symptoms without use of needles, XRays or dye. Cilostazol was FDA approved due to the proof that it is effective for many patients. Yet, experience in use of this – like many medications – can make this choice more effective for you.  As an inexpensive, nearly risk-free approach, this should be considered for many patients with claudication.

Endovascular Therapies

Endovascular Therapies

The use of catheter-based techniques that can open blocked arteries is also proven to improve symptoms in patients with PAD and claudication. As an X-ray based procedure, a small incision is made in numbed skin, a device is threaded to the blockage, and many arteries blocked by a cholesterol plaque can now be opened via a variety of techniques:

  • Angioplasty: A balloon-tipped catheter is placed into the artery and advanced to the obstructed area. The balloon is inflated to expand the blockage, and then deflated and retrieved, widening the narrowed artery
  • Stenting: Performed during angioplasty, a mesh-like tube is inserted at the cholesterol blockage and is expanded permanently into the vessel wall to keep the blockage open
  • Atherectomy: A specialized catheter with directable cutting blades or a drill is advanced through the cholesterol plaque to removing the blockage from the artery wall to restore blood flow

Surgical Techniques

Surgical Techniques

Surgical techniques can also be useful:

  • Endarterectomy: A blocked artery is exposed from a surgical incision and then opened. The plaque is then removed to widening the blocked artery
  • Surgical Bypass: Blood flow is rerouted around the blocked blood vessel by attaching a either a vein harvested from the body, or a plastic tube, above and below the point of obstruction

In close collaboration with University of Minnesota interventional cardiologists, vascular surgeons and radiologists, coordinating care at the University of Minnesota Cardiovascular Center, all endovascular and surgical options are available.