Intermittent claudication: The natural history

Intermittent claudication is a relatively common disorder, present in a subset of patients with lower extremity atherosclerotic disease. Although lower extremity morbidity rates are low, patients with claudication frequently have coexistent cardiovascular disease and are at significantly increased risk of adverse cardiovascular events. Data to support work-up for concomitant coronary artery disease in conservatively managed patients are not available; however, clinicians should consider the high prevalence of coronary artery disease when developing management strategies. Patients should be carefully selected for lower extremity interventional management given the generally benign lower extremity prognosis. Tobacco smokers should be urged to quit, owing to their higher rate of lower extremity and cardiovascular adverse outcomes. Functional outcomes after various treatment strategies have not yet been sufficiently studied in the claudicant.