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Inicio Angiología Claudicación intermitente en el adulto joven: arteriopatía no arterioscleróti...
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Vol. 54. Núm. 3.
Páginas 182-196 (Enero 2002)
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Vol. 54. Núm. 3.
Páginas 182-196 (Enero 2002)
DOI: 10.1016/S0003-3170(02)74743-3
Acceso a texto completo
Claudicación intermitente en el adulto joven: arteriopatía no arteriosclerótica
Intermittent claudication in young adults: non-arteriosclerotic arteriopathy
Claudicação intermitente no adulto jovem: arteriopatia não arteriosclerótica
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J.I. Blanes-Mompó
Autor para correspondencia
lochv@arrakis.es

correspondence: Servicio de Angiologia y Cirugía Vascular. Hospital Universitario Dr. Peset. Avda. Gaspar Aguilar, 90. E-46017 Valencia. Fax: +34 963 861 914.
, I. Crespo-Moreno, F.G. ómez-Palonés, S. Martínez-Meléndez, I. Martínez-Perelló, E. Ortiz-Monzón, J. Zaragoza-García, R. Verdejo-Tamarit
Servicio de Angiología y Cirugía Vascular y Endo-vascular. Hospital Universitario Dr. Peset. Valencia, España.
Información del artículo
Summary
Aim

Intermittent claudication in young adults (ICYA) of a non-arteriosclerotic etiology is an infrequent disorder and this means that on many occasions diagnosis is delayed in generally active patients, leading to incapacity and loss of productivity. The purpose of this paper is to describe the different non-arteriosclerotic processes that can trigger off intermittent claudication (IC) in this group of patients, and to highlight its differential characteristics.

Development

The non-arteriosclerotic pathologies that can produce ICYA are described, and a young adult is taken as being anyone under the age of 40. Due to their affecting the system as a whole, we did not include vasculitis, except for thromboangiitis obliterans and Takayasu's disease, since they very often only occurred with claudication. We consider anomalies arising during the course of embryological development, such as popliteal entrapment (PE), adventitial cyst disease and persistent sciatic artery; stenoses and obstructions of the abdominal aorta: aortic coarctation, aortic hypoplasia and Takayasu's disease; arterial lesions in those who practise sports: functional popliteal entrapment, adductors (Hunter's) canal syndrome, dissection of the external iliac, endofibrosis of the external iliac and chronic compartmental syndrome; ergotism; thromboangiitis obliterans; as well as: fibromuscular dysplasia, traumatic obstruction and actinic arthritis.

Conclusions

Knowledge of the different causes of non-arteriosclerotic ICYA prevents delays in diagnoses and allows treatment to be started at an early stage, which will help this group of patients to make a quicker return to their normal activity.

Key words:
Arterial pathology
Intermittent claudication
Ischemia
Young adult
Resumen
Objetivo

La claudicación intermitente en el adulto joven (CIAJ) de etiología no arteriosclerótica es una entidad poco frecuente, lo que provoca, en muchas ocasiones, retrasos diagnósticos en pacientes generalmente activos, con la consiguiente incapacidad y pérdida de productividad. El objetivo de este artículo es describir los distintos procesos no arterioscleróticos que pueden provocar claudicación intermitente (CIN) en este grupo de pacientes, y hacer hincapié en sus características diferenciales.

Desarrollo

Se describen las patologías no arterioscleróticas que pueden producir CIAJ; se considera adulto joven aquel con menos de 40 años de edad. Se excluyen las vasculitis, debido a su afectación sistémica, con excepción de la tromboangitis obliterante y la enfermedad de Takayasu, por presentarse, en muchas ocasiones, únicamente con claudicación. Se incluyen las anomalías del desarrollo embriológico: atrapamiento poplíteo (AP), enfermedad quística adventicial y arteria ciática persistente; las estenosis y obstrucciones de la aorta abdominal: coartación aórtica, hipoplasia aórtica y enfermedad de Takayasu; las lesiones arteriales de los deportistas: AP funcional, síndrome del canal de los aductores, disección de la ilíaca externa, endofibrosis de la ilíaca externa y síndrome compartimental crónico; el ergotismo; la tromboangitis obliterante; y otras: displasia fibromuscular, obstrucción traumática y arteritis actínicas.

Conclusiones

El conocimiento de las distintas causas de CIN no arteriosclerótica en el adulto joven evita demoras diagnósticas y permite un tratamiento precoz, lo que facilita la reincorporación temprana de este grupo de pacientes a su actividad habitual.

Palabras clave:
Adulto joven
Claudicación intermitente
Isquemia
Patología arterial
Resumo
Objectivo

A claudicação intermitente no adulto jovem (CIAJ) de etiologia não arteriosclerótica è uma entidade pouco frequente, o que provoca, em muitas ocasiões, atrasos diagnósticos em doentes geralmente activos, com conseguinte incapacidade e perda deprodutividade. O objectivo deste artigo é descrever os distintos processos não arterioscleróticos que podem provocar claudicação intermitente (CIN) neste grupo de doentes, e insistir sobre as suas características diferenciais.

Desenvolvimento

Descrevem-se as patologias não arterioscleróticas que podem produzir CIAJ; considera-se como adulto jovem aquele menor de 40 anos. Excluíram-se as vasculites, devido à sua afectação sistémica, à excepção da tromboangeíte obliterante e a doença de Takayasu, por se apresentarem, em muitas ocasiões, unicamente com clau-dicação. Incluem-se as anomalias do des-envolvimento embriológico: entrapment popliteu (EP), doença quística da adventícia e artéria ciática persistente; as estenoses e obstruções da aorta abdominal: coartação aórtica, hipoplasia aórtica e doença de Takayasu; as lesões arteriais dos desportis-tas: AP funcional, síndroma do canal dos abdutores, dissecção da ilíaca externa, en-dofibrose da ilíaca externa e síndroma compartimental crónica; o ergotismo; a tromboangeíte obliterante; e outras: displasia fibromuscular, obstrução traumática e arterite actínicas.

Conclusões

O conhecimento das causas distintas de CIN não arterios-clerótica no adulto jovem evita demoras diagnosticas e permite um tratamento precoce, o que favorece a reincorporação tempestiva deste grupo de doentes na sua actividade habitual.

Palavras clave:
Adulto jovem
Claudicacao intermitente
Isquemia
Patologia arterial
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