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Vascular Medicine, Vol. 7, No. 4, 301-309 (2002)
DOI: 10.1191/1358863x02vm447ra
© 2002 SAGE Publications

Pharmacologic treatment for intermittent claudication

Steven M Dean

Vascular Services of Ohio, Columbus, OH, USA, sdean1{at}columbus.rr.com

In contradistinction to chronic critical limb ischemia, the peripheral arterial disease patient with intermittent claudication is at relatively low risk for limb loss. As a result, initial claudication management should employ non-interventional therapies rather than immediate catheter-based or surgical revascularization. Although exercise therapy is the most efficacious conservative treatment for claudication, supervised exercise programs are not widely available at present. Consequently, a pharmacologic agent can be utilized to lessen the symptoms and improve the function of the claudicant. This manuscript provides a comprehensive review of the various pharmacotherapies that have been investigated for improving walking distance in the setting of intermittent claudication. Cilostazol, a phosphodiesterase III inhibitor, appears to provide the greatest benefit, significantly improving not only walking distance but quality of life as well. Early trials indicate that propionyl-l-carnitine, oral prostaglandins, l-arginine, and therapeutic angiogenesis may eventually yield significant benefit in lessening the symptoms of intermittent claudication.

Key Words: claudication • peripheral arterial disease • pharmacotherapy


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