The hidden side of calf claudication: Hemodynamic and clinical results of treadmill testing in 584 patients complaining of isolated exertional calf pain
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-tcpO2). The Edinburgh Claudication Questionnaire (ECQ) was self-completed before and during a treadmill test. For calf and non-calf (buttock and thigh) Ex-tcpO2, a lowest decrease of rest of oxygen pressure (DROP) < -15 mmHg was indicative of ischemia. We selected the patients that reported calf claudication only and analyzed minimal DROP and per-test ECQ observations.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-tcpO2 (i.e. calf symptoms associated to calf ischemia) was observed in only 114 (19.5%) cases.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.
Domaines
Sciences du Vivant [q-bio]Origine | Fichiers produits par l'(les) auteur(s) |
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