[Arterial claudication].

Abstract

The authors recall that in their report presented to the 79th French Congress of Surgery (September, 1977), they included the results of 26,632 chronic obstructive arteriopathies, 49.8% of them at the intermittent claudication stage. Medical treatment was initially proposed in 27% of cases. The results were followed up in 1,660 patients. At term (8 years and more), there were good results in only one third of the patients, and 28% of the patients had to be operated on. Lumbar sympathectomy was practiced on an isolated basis in 35% of cases. At the cost of a minimal (0.7%) mortality rate, with improvement beyond eight years in 61.5% of patients, and only 19% having to undergo direct revascularization. Direct revascularization was proposed in 38% of cases. At the aorto-iliac stage, thrombo-endarterectomies and single and bi-lateral prothetic bridgings gave very similar results: a mortality rate of 3.4% on the average, with good results beyond eight years in 76.6% of patients. Direct revascularizations are practiced almost as often on the femoro-popliteal level for simple intermittent claudications. Mortality is low (1%), and the long-range results similar (76.4% of good results beyond 8 years), but the installation of a prothesis at the femoro-popliteal stage so often fails that it should not be done if the intermittent claudication is tolerable. Surgery plays a prime role in the treatment of claudications of arterial origin, a role that the success and the continuation of the good results, when applied under the proper conditions, amply justifies.