Intermittent claudication should not be treated by surgery.

Abstract

This debate examines the proposition that surgery is unnecessary or obsolete in the management of intermittent claudication. The case for this argument is that many patients have stable disease or respond well to conservative measures, that claudication is an expression of a systemic cardiovascular illness and that surgery can be replaced by endovascular techniques with equal success, and less disadvantage in the event of treatment failure. The case against the motion is that claudication is associated with repeated cycles of ischaemia and reperfusion, and that these contribute to excess cardiovascular mortality states and, furthermore, that surgery is the only option to relieve symptoms for many patients, especially those with distal disease.