The hidden side of calf claudication: Hemodynamic and clinical results of treadmill testing in 584 patients complaining of isolated exertional calf pain.


Journal

Atherosclerosis
ISSN: 1879-1484
Titre abrégé: Atherosclerosis
Pays: Ireland
ID NLM: 0242543

Informations de publication

Date de publication:
12 2020
Historique:
received: 07 05 2020
revised: 07 10 2020
accepted: 28 10 2020
pubmed: 8 11 2020
medline: 24 6 2021
entrez: 7 11 2020
Statut: ppublish

Résumé

Calf pain is the most frequent symptom of arterial claudication. We hypothesized that patients with self-reported isolated calf claudication have frequent exertional non-calf symptoms during objective laboratory testing, and that many would show not only distal, but also proximal ischemia. We retrospectively analyzed the patients referred since 2016 for exercise transcutaneous oxygen pressure (Ex-tcpO Exertional symptoms on a treadmill occurred in 526 (90.1%) of the 584 patients analyzed (65.6 ± 11.4 years old), with 391 (74.3%) of these symptoms affecting only the calf. Isolated calf ischemia with or without symptoms was found in only 139 (23.8%) patients. Overall, among the 584 patients self-reporting isolated calf symptoms, a perfect concordance between symptoms on a treadmill and Ex-tcpO Our study demonstrated that patients self-reporting exertional limb pain strictly limited to the calf may also have non-calf claudication on a treadmill and frequently show not-only-calf ischemia. These observations are important when planning reeducation or when studying the tissue consequences of ischemia in patients with claudication.

Sections du résumé

BACKGROUND AND AIMS
Calf pain is the most frequent symptom of arterial claudication. We hypothesized that patients with self-reported isolated calf claudication have frequent exertional non-calf symptoms during objective laboratory testing, and that many would show not only distal, but also proximal ischemia.
METHODS
We retrospectively analyzed the patients referred since 2016 for exercise transcutaneous oxygen pressure (Ex-tcpO
RESULTS
Exertional symptoms on a treadmill occurred in 526 (90.1%) of the 584 patients analyzed (65.6 ± 11.4 years old), with 391 (74.3%) of these symptoms affecting only the calf. Isolated calf ischemia with or without symptoms was found in only 139 (23.8%) patients. Overall, among the 584 patients self-reporting isolated calf symptoms, a perfect concordance between symptoms on a treadmill and Ex-tcpO
CONCLUSIONS
Our study demonstrated that patients self-reporting exertional limb pain strictly limited to the calf may also have non-calf claudication on a treadmill and frequently show not-only-calf ischemia. These observations are important when planning reeducation or when studying the tissue consequences of ischemia in patients with claudication.

Identifiants

pubmed: 33160245
pii: S0021-9150(20)31487-8
doi: 10.1016/j.atherosclerosis.2020.10.891
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

41-47

Informations de copyright

Copyright © 2020 Elsevier B.V. All rights reserved.

Auteurs

Pierre Ramondou (P)

Vascular Medicine, University Hospital Center, 4 Rue Larrey, 49000, Angers, France; MitoVasc Institute UMR CNRS 6015 / INSERM 1083, Faculty of Medicine, Angers University, Rue Haute de Reculée, 49000, Angers, France.

Wendsendaté Yves Sempore (WY)

Université Nazi Boni, Bobo Dioulasso, Burkina Faso.

Céline Guilleron (C)

MitoVasc Institute UMR CNRS 6015 / INSERM 1083, Faculty of Medicine, Angers University, Rue Haute de Reculée, 49000, Angers, France; UMR CNRS 6613 LAUM, Le Mans University, Avenue Olivier Messiaen, 72000, Le Mans, France.

Jeanne Hersant (J)

Vascular Medicine, University Hospital Center, 4 Rue Larrey, 49000, Angers, France.

Nafi Ouedraogo (N)

Université Nazi Boni, Bobo Dioulasso, Burkina Faso.

Pierre Abraham (P)

Vascular Medicine, University Hospital Center, 4 Rue Larrey, 49000, Angers, France; MitoVasc Institute UMR CNRS 6015 / INSERM 1083, Faculty of Medicine, Angers University, Rue Haute de Reculée, 49000, Angers, France; Service of Sports Medicine, University Hospital, 4 Rue Larrey, 49000, Angers, France. Electronic address: PiAbraham@chu-angers.fr.

Samir Henni (S)

Vascular Medicine, University Hospital Center, 4 Rue Larrey, 49000, Angers, France; MitoVasc Institute UMR CNRS 6015 / INSERM 1083, Faculty of Medicine, Angers University, Rue Haute de Reculée, 49000, Angers, France.

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Classifications MeSH