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Evidenzbasierte Gefäßchirurgie pp 143–161Cite as

Claudicatio intermittens

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Part of the book series: Evidenzbasierte Chirurgie ((EC))

Zusammenfassung

Bei Patienten mit Claudicatio intermittens wird ein überwachtes Übungsprogramm als Primärtherapie empfohlen, um Funktionsstatus und Lebensqualität zu verbessern und die Beinsymptome zu verringern. Patienten, bei denen ein Gehtraining unmöglich ist, wenig erfolgversprechend ist oder nicht erfolgreich war, kann bei geeigneter Gefäßläsion eine interventionelle Behandlung zur Verbesserung der Lebensqualität angeboten werden. Gefäßchirurgische Maßnahmen kommen erst an 3. Stelle und sollten Patienten mit Claudicatio intermittens nur bei hohem Leidensdruck angeboten werden, wenn die endovaskulären Verfahren nicht erfolgreich waren oder ungeeignet sind, oder wenn die chirurgischen Verfahren für den Patienten geeigneter erscheinen.

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Literatur

  • Aboyans V, Ricco JB, Bartelink MEL et al (2018) 2017 ESC guidelines on the diagnosis and treatment of peripheral arterial diseases, in collaboration with the European Society for Vascular Surgery (ESVS): document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries. Endorsed by: the European Stroke Organization (ESO) the task force for the diagnosis and treatment of peripheral arterial diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). Eur Heart J 39:763–816

    Article  Google Scholar 

  • Conte MS, Pomposelli FB, Clair DG et al, Society for Vascular Surgery Lower Extremity Guidelines Writing Group (2015) Society for vascular surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: management of asymptomatic disease and claudication. J Vasc Surg 61(3 Suppl):2S–41S

    Google Scholar 

  • Devine EB, Alfonso-Cristancho R, Yanez ND et al, Comparative Effectiveness Research Translation Network (CERTAIN) Collaborative (2016) Effectiveness of a medical vs revascularization intervention for intermittent leg claudication based on patient-reported outcomes. JAMA Surg 151:e162024

    Article  Google Scholar 

  • Dörenkamp S, Mesters I, de Bie R, Teijink J, Breukelen G van (2016) Patient characteristics and comorbidities influence walking distances in symptomatic peripheral arterial disease: a large one-year physiotherapy cohort study. PLoS One 11(1):e0146828

    Article  Google Scholar 

  • Fakhry F, Fokkenrood HJ, Spronk S, Teijink JA, Rouwet EV, Hunink MGM (2018) Endovascular revascularisation versus conservative management for intermittent claudication. Cochrane Database Syst Rev 3:CD010512

    Google Scholar 

  • Gerhard-Herman MD, Gornik HL, Barrett C et al (2017) 2016 AHA/ACC guideline on the management of patients with lower extremity peripheral artery disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 69:e71–e126

    Article  Google Scholar 

  • Golledge J, Moxon JV, Rowbotham S, Pinchbeck J, Yip L, Velu R, Quigley F, Jenkins J, Morris DR (2018) Risk of major amputation in patients with intermittent claudication undergoing early revascularization. Br J Surg 105:699–708

    Article  CAS  Google Scholar 

  • Hageman D, Gommans LN, Scheltinga MR, Teijink JA (2017a) Effect of diabetes mellitus on walking distance parameters after supervised exercise therapy for intermittent claudication: A systematic review. Vasc Med 22:21–27

    Article  Google Scholar 

  • Hageman D, Fokkenrood HJP, Essers PPM, Koelemay MJW, Breek JC, Vahl AC, Scheltinga MRM, Teijink JAW (2017b) Improved adherence to a stepped-care model reduces costs of intermittent claudication treatment in the Netherlands. Eur J Vasc Endovasc Surg 54:51–57

    Article  CAS  Google Scholar 

  • Hageman D, Pesser N, Gommans LNM, Willigendael EM, Sambeek MRHM van, Huijbers E, Snoeijen A, Scheltinga MRM, Teijink JAW (2018) Limited adherence to peripheral arterial disease guidelines and suboptimal ankle brachial index reliability in Dutch primary care. Eur J Vasc Endovasc Surg 55:867–873

    Article  Google Scholar 

  • Harwood AE, Smith GE, Cayton T, Broadbent E, Chetter IC (2016) A systematic review of the uptake and adherence rates to supervised exercise programs in patients with intermittent claudication. Ann Vasc Surg 34:280–289

    Article  Google Scholar 

  • Harwood AE, Green J, Cayton T, Raza A, Wallace T, Carradice D, Chetter IC, Smith GE (2018) A feasibility double-blind randomized placebo-controlled trial of extracorporeal shockwave therapy as a novel treatment for intermittent claudication. J Vasc Surg 67:514–521

    Article  Google Scholar 

  • Houten MM van den, Lauret GJ, Fakhry F, Fokkenrood HJ, Asselt AD van, Hunink MG, Teijink JA (2016) Cost-effectiveness of supervised exercise therapy compared with endovascular revascularization for intermittent claudication. Br J Surg 103:1616–1625

    Article  Google Scholar 

  • Jongsma H, Bekken JA, de Vries JP, Verhagen HJ, Fioole B (2016) Drug-eluting balloon angioplasty versus uncoated balloon angioplasty in patients with femoropopliteal arterial occlusive disease. J Vasc Surg 64:1503–1514

    Article  Google Scholar 

  • Kalbaugh CA, Gonzalez NJ, Luckett DJ, Fine J, Brothers TE, Farber MA, Beck AW, Hallett JW Jr, Marston WA, Vallabhaneni R (2018) The impact of current smoking on outcomes after infrainguinal bypass for claudication. J Vasc Surg 68:495–502

    Article  Google Scholar 

  • Kayssi A, Al-Atassi T, Oreopoulos G, Roche-Nagle G, Tan KT, Rajan DK (2016) Drug-eluting balloon angioplasty versus uncoated balloon angioplasty for peripheral arterial disease of the lower limbs. Cochrane Database Syst Rev (8):CD011319

    Google Scholar 

  • Klaphake S, Buettner S, Ultee KH, Rijn MJ van, Hoeks SE, Verhagen HJ (2018) Combination of endovascular revascularization and supervised exercise therapy for intermittent claudication: a systematic review and meta-analysis. J Cardiovasc Surg (Torino) 59:150–157

    Google Scholar 

  • Klingelhoefer E, Bergert H, Kersting S, Ludwig S, Weiss N, Schönleben F, Grützmann R, Gäbel G (2016) Predictive factors for better bypass patency and limb salvage after prosthetic above-knee bypass reconstruction. J Vasc Surg 64:380–388

    Article  Google Scholar 

  • Krishnan P, Faries P, Niazi K et al (2017) Stellarex drug-coated balloon for treatment of femoropopliteal disease: twelve-month outcomes from the randomized ILLUMENATE pivotal and pharmacokinetic studies. Circulation 136:1102–1113

    Article  CAS  Google Scholar 

  • Kumakura H, Kanai H, Hojo Y, Iwasaki T, Ichikawa S (2017) Long-term survival and fate of the leg in de novo intermittent claudication. Eur Heart J Qual Care Clin Outcomes 3:208–215

    PubMed  Google Scholar 

  • Lane R, Harwood A, Watson L, Leng GC (2017) Exercise for intermittent claudication. Cochrane Database Syst Rev12:CD000990

    Google Scholar 

  • Lawall H, Huppert P, Rümenapf G, Deutsche Gesellschaft für Angiologie – Gesellschaft für Gefäßmedizin (2015) S3-Leitlinie zur Diagnostik, Therapie und Nachsorge der peripheren arteriellen Verschlusskrankheit. AWMF-Register Nr. 065/003

    Google Scholar 

  • Lindgren H, Qvarfordt P, Åkesson M, Bergman S, Gottsäter A, Swedish Endovascular Claudication Stenting Trialists (2017) Primary stenting of the superficial femoral artery in intermittent claudication improves health related quality of life, ABI and walking distance: 12 month results of a controlled randomised multicentre trial. Eur J Vasc Endovasc Surg 53:686–694

    Google Scholar 

  • Mazari FA, Khan JA, Samuel N, Smith G, Carradice D, McCollum PC, Chetter IC (2017) Long-term outcomes of a randomized clinical trial of supervised exercise, percutaneous transluminal angioplasty or combined treatment for patients with intermittent claudication due to femoropopliteal disease. Br J Surg 104:76–83

    Article  CAS  Google Scholar 

  • McPhee JT, Madenci A, Raffetto J, Martin M, Gupta N (2016) Contemporary comparison of aortofemoral bypass to alternative inflow procedures in the Veteran population. J Vasc Surg 64:1660–1666

    Article  Google Scholar 

  • Nordanstig J, Taft C, Hensäter M, Perlander A, Österberg K, Jivegård L (2016) Two-year results from a randomized clinical trial of revascularization in patients with intermittent claudication. Br J Surg 103:1290–1299

    Article  CAS  Google Scholar 

  • Ochoa Chaar C, Shebl F, Sumpio B, Dardik A, Indes J, Sarac T (2017) Distal embolization during lower extremity endovascular interventions. J Vasc Surg 66:143–150

    Article  Google Scholar 

  • Ohki T, Kichikawa K, Yokoi H, Uematsu M, Yamaoka T, Maeda K, Kanaoka Y (2017) Outcomes of the Japanese multicenter Viabahn trial of endovascular stent grafting for superficial femoral artery lesions. J Vasc Surg 66:130–142

    Article  Google Scholar 

  • Oresanya L, Mazzei M, Bashir R, Farooqui A, Athappan G, Roth S, Choi ET, Bemmelen P van (2018) Systematic review and meta-analysis of high-pressure intermittent limb compression for the treatment of intermittent claudication. J Vasc Surg 67:620–628

    Article  Google Scholar 

  • Pandey A, Banerjee S, Ngo C, Mody P, Marso SP, Brilakis ES, Armstrong EJ, Giri J, Bonaca MP, Pradhan A, Bavry AA, Kumbhani DJ (2017) Comparative efficacy of endovascular revascularization versus supervised exercise training in patients with intermittent claudication: meta-analysis of randomized controlled trials. JACC Cardiovasc Interv 10:712–724

    Article  Google Scholar 

  • Rocha-Singh KJ, Beckman JA, Ansel G, Lyden SP, Schneider P, Mehta M, Dake M, Mullin CM, Jaff MR, VIVA Physicians, Inc (2017) Patient-level meta-analysis of 999 claudicants undergoing primary femoropopliteal nitinol stent implantation. Catheter Cardiovasc Interv 89:1250–1256

    Article  Google Scholar 

  • Schroeder H, Werner M, Meyer DR, Reimer P, Krüger K, Jaff MR, Brodmann M, ILLUMENATE EU RCT Investigators (2017) Low-dose paclitaxel-coated versus uncoated percutaneous transluminal balloon angioplasty for femoropopliteal peripheral artery disease: One-year results of the ILLUMENATE European randomized clinical trial (randomized trial of a novel paclitaxel-coated percutaneous angioplasty balloon). Circulation 135:2227–2236

    Article  CAS  Google Scholar 

  • Siracuse JJ, Van Orden K, Kalish JA, Eslami MH, Schermerhorn ML, Patel VI, Rybin D, Farber A, Vascular Quality Initiative (2017) Endovascular treatment of the common femoral artery in the Vascular Quality Initiative. J Vasc Surg 65:1039–1046

    Google Scholar 

  • Sridharan ND, Boitet A, Smith K, Noorbakhsh K, Avgerinos E, Eslami MH, Makaroun M, Chaer R (2018) Cost-effectiveness analysis of drug-coated therapies in the superficial femoral artery. J Vasc Surg 67:343–352

    Article  Google Scholar 

  • Stoner MC, Calligaro KD, Chaer RA, Dietzek AM, Farber A, Guzman RJ, Hamdan AD, Landry GJ, Yamaguchi DJ, Society for Vascular Surgery (2016). Reporting standards of the society for vascular surgery for endovascular treatment of chronic lower extremity peripheral artery disease. J Vasc Surg 64:e1–e21

    Google Scholar 

  • Thieme M, Von Bilderling P, Paetzel C, Karnabatidis D, Perez Delgado J, Lichtenberg M; Lutonix Global SFA Registry Investigators (2017) The 24-month results of the Lutonix Global SFA registry: worldwide experience with lutonix drug-coated balloon. JACC Cardiovasc Interv 10:1682–1690

    Google Scholar 

  • Thieme M, Lichtenberg M, Brodmann M, Cioppa A, Scheinert D (2018) Lutonix® 014 DCB global below the knee registry study: interim 6-month outcomes. J Cardiovasc Surg (Torino) 59:232–236

    Google Scholar 

  • Van Schaardenburgh M, Wohlwend M, Rognmo Ø, Mattsson E (2017) Calf raise exercise increases walking performance in patients with intermittent claudication. J Vasc Surg 65:1473–1482

    Article  Google Scholar 

  • Wieker CM, Schönefeld E, Osada N, Lührs C, Beneking R, Torsello G, Böckler D (2016) Results of common femoral artery thromboendarterectomy evaluation of a traditional surgical management in the endovascular era. J Vasc Surg 64:995–1001

    Article  Google Scholar 

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Authors and Affiliations

  1. Klinik und Poliklinik für Gefäßmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

    E. Sebastian Debus

  2. ehem. Wissenschaftlicher Medizinischer Direktor Kreiskliniken Altötting-Burghausen, Burghausen, Bayern, Deutschland

    Reinhart T. Grundmann

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  1. E. Sebastian Debus
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  2. Reinhart T. Grundmann
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Correspondence to E. Sebastian Debus .

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Debus, E.S., Grundmann, R.T. (2019). Claudicatio intermittens. In: Evidenzbasierte Gefäßchirurgie. Evidenzbasierte Chirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-57709-7_11

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  • DOI: https://doi.org/10.1007/978-3-662-57709-7_11

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-57708-0

  • Online ISBN: 978-3-662-57709-7

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