Buscar en
Angiología
Toda la web
Inicio Angiología Tratamiento médico de la claudicación intermitente
Información de la revista
Vol. 54. Núm. 3.
Páginas 162-173 (Enero 2002)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 54. Núm. 3.
Páginas 162-173 (Enero 2002)
DOI: 10.1016/S0003-3170(02)74741-X
Acceso a texto completo
Tratamiento médico de la claudicación intermitente
The medical treatment of intermittent claudication
Tratamento médico da claudicação intermitente
Visitas
...
C. Corominas-Roura
Autor para correspondencia
croura@hsd.es

correspondence: Monti-Sion, 18.E.07001 Palma de Mallorca, Illes Balears
, A. Plaza-Martínez, M. Díaz López, R. Riera-Vázquez, J. Cordobés-Gual
Servicio de Angiología y Cirugía Vascular. Hospital Universitari Son Dureta. Palma de Mallorca, Illes Balears, España.
Información del artículo
Summary
Introduction

The diagnosis of intermittent claudication due to arteriosclerosis of the arteries of the lower limbs implies a significant increase in the risk of cardiovascular complications (CVC) and markedly reduced quality of life.

Objective

To consider the modification of risk factors for the progression of arteriosclerosis as the main factor in treatment.

Conclusions

Aspirin is the drug offirst choice in the secondary prevention of CVC in patients with peripheral arterial disease, and clopidogrel, which is potentially the most effective, is an alternative treatment for patients with chronic ischaemia of the lower limbs. The currently available data is not sufficient to be able to recommend the systematic use of a specific drug in all patients with claudication.

Key words:
Arteriosclerosis
Aspirin
Chronic ischaemia
Clopidogrel
Intermittent claudication
Lower limbs
Resumen
Introducción

El diagnóstico de claudicación intermitente por afectación arteriosclerótica de las arterias de las extremi dades inferiores (EEII) implica un incremento significativo del riesgo de complicaciones cardiovasculares (CCV), así como una limitación importante de la calidad de vida.

Objetivo

Considerar la modificación de los factores de riesgo de progresión de la arteriosclerosis como factor prioritario de trata miento.

Conclusiones

La aspirina constitu ye el fármaco de primera elección en la prevención secundaria de las CCV en pacientes con enfermedad arterial periférica, y elclopidogrel, con efecto potencialmente más eficaz, representa una alternativa en pacientes con isquemia crónica de las EEII. Los datos actuales son insuficientes para recomendar el uso sistemático de un fármaco específico en todos los pacientes con claudicación.

Palabras clave:
Arteriosclerosis
Aspirina
Claudicación intermitente
Clopidogrel
Extremidades inferiores
Isquemia crónica
Resumo
Introdução

O diagnóstico da claudicação intermitente por envolvimento arteriosclerótico das artérias dos membros inferiores (MI) implica um incremento significativo do risco das complicações cardiovasculares (CCV), bem como uma limitação importante da qualidade de vida.

Objectivo

Considerar a modificação dos factores de risco da progressão da arteriosclerose como factor prioritário de tratamento.

Conclusões

A aspirina constitui o fármaco de primeira escolha na prevenção secundária das CCV em doentes com doença arterial periférica, e o clopidogrel, com efeito potencialmente mais eficaz, representa uma alternativa em doentes com isquemia crónica dos MI. Os dados actuais são insuficientes para recomendar a utilização sistemáti ca de um fármaco específico em todos os doentes com claudicação.

Palavras clave:
Arteriosclerose
Aspirina
Claudicação intermitente
Clopidogrel
Membros inferiores
Isquemia crónica
El Texto completo está disponible en PDF
Bibliografía
[1.]
C.M. Pratt, A.J. Comerota.
New therapeutic options in the management of claudication.
[2.]
W.R. Hiatt.
Medical treatment of peripheral arterial disease and claudication.
N Engl J Med., 344 (2001), pp. 1608-1621
[3.]
J.I. Weitz, J. Byrne, P. Clagett, M.E. Farkouh, J.M. Porter, D.L. Sackett, et al.
Diagnosis and treatment of chronic arterial insufficiency of the lower extremities: a critical review.
Circulation, 94 (1996), pp. 3026-3049
[4.]
Trans-Atlantic Inter-Society Consensus.
Management of peripheral arterial disease.
J Vasc Surg., (2000), pp. 31
[5.]
R.J. Valentine, M.R. Jackson, G. Modrall, K.E. McIntyre, P. Clagett.
The progressive nature of peripheral arterial disease in young adults: a prospective analysis of white men referred to a vascular surgery service.
J Vasc Surg., 30 (1999), pp. 436-445
[6.]
G.A. Rose.
The diagnosis of ischaemic heart pain and intermittent claudication in field surveys.
Bull WHO, 27 (1962), pp. 645-658
[7.]
G.C. Leng, F.G.R. Fowkes.
The Edinburgh Claudication Questionnaire: an improved version of the WHO/Rose Questionnaire for use in epidemiological surveys.
J Clin Epidemiol, 45 (1992), pp. 1101-1109
[8.]
M. Schroll, O. Munck.
Estimation of peripheral arteriosclerotic disease by ankle blood pressure measurements in a population study of 60 year old men and women.
J Chron Dis, 34 (1981), pp. 261-269
[9.]
Regensteiner JG. Medical management of intermittent claudication. Vasc Surg Highlights 2000-2001.
[10.]
G.J. Hicken, A.G. Lossing, F.M. Ameli.
Assessment of generic health-related quality of life in patients with intermittent claudication.
Eur J Vasc Endovasc Surg., 20 (2000), pp. 336-341
[11.]
W.S. Aronow, C. Ahn.
Prevalence of coexistence of coronary artery disease, peripheral arterial disease and aterothrombotic brain infarction in men and women < 62 years of age.
Am J Cardiol, 74 (1994), pp. 64-65
[12.]
CAPRIE Steering committee.
A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischemic events (CAPRIE).
Lancet, 348 (1996), pp. 1329-1339
[13.]
K.A. Eagle, C.S. Rihal, E.D. Foster, M.C. Mickel, B.J. Gersh.
Long-term survival in patients with coronary artery disease: importance of peripheral vascular disease.
The Coronary Artery Surgery Study (CASS) Investigators. J Am Coll Cardiol, 5 (1994), pp. 1091-1095
[14.]
The Cochrane Library. Exercise, bluflomedil, anticoagulants, pentoxyfiline, L-carnitine, garlic and vitamin E for intermittent claudication. Cochrane Review (varias fechas).
[15.]
T.R. Pedersen, J. Kjekshus, K. Pyorala, A.G. Olsson, T.J. Cook, T.A. Musliner, et al.
Effect of simvastatin on ischemic signs and symptoms in the Scandinavian simvastatin survival study (4S).
Am J Cardiol, 81 (1998), pp. 333-335
[16.]
Antiplatelet Trialist Collaboration.
Collaborative overview of randomised trials of antiplatelet therapy.
Br Med J, 308 (1994), pp. 81-106
[17.]
K.H. Tan, D. Cotterrell, K. Sykes, G.R.J. Sissons, L. de Cossart, P.R. Edwards.
Exercise training for claudicants: changes in blood flow, cardio-respiratory status, metabolic functions, blood rheology and lipid profile.
Eur J Vasc Endovasc Surg., 20 (2000), pp. 72-78
[18.]
R.B. Patterson, B. Pinto, B. Marcus, A. Colucci, T. Braun, M. Roberts.
Value of a supervised exercise program for the therapy of arterial claudication.
J Vasc Surg., 25 (1997), pp. 312-319
[19.]
S.R. Money, J.A. Herd, J.L. Isaacshon, M. Davidson, B. Cutler, J. Heckman, et al.
Effect of cilostazol on walking distances in patients with intermittent claudication caused by peripheral vascular disease.
J Vasc Surg., 27 (1998), pp. 267-275
[20.]
H.G. Beebe, D.L. Dawson, B.S. Cutler, J.A. Herd, D.E. Strandness Jr., E.B. Bortey, et al.
A new pharmacological treatment for intermittent claudication: results of a randomized, multicenter trial.
Arch Intern Med., 159 (1999), pp. 2041-2050
Copyright © 2002. SEACV
Opciones de artículo
Herramientas
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

es en pt
Política de cookies Cookies policy Política de cookies
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here. Utilizamos cookies próprios e de terceiros para melhorar nossos serviços e mostrar publicidade relacionada às suas preferências, analisando seus hábitos de navegação. Se continuar a navegar, consideramos que aceita o seu uso. Você pode alterar a configuração ou obter mais informações aqui.