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Intermittent claudication is a symptom and is by definition diagnosed by a patient reporting a history of leg pain with walking relieved by rest. However, as other conditions such as sciatica can mimic intermittent claudication, testing is often performed to confirm the diagnosis of peripheral artery disease .
Although cilostazol would not be approvable for a trivial condition the Cardio-Renal Advisory Committee and FDA concluded that fully informed patients and physicians should be able to choose to use it to treat intermittent claudication. Patient and physician labeling will describe the basis for concern and the incomplete information available. [6]
The prognosis for patients with peripheral vascular disease due to atherosclerosis is poor; patients with intermittent claudication due to atherosclerosis are at increased risk of death from cardiovascular disease (e.g. heart attack), because the same disease that affects the legs is often present in the arteries of the heart. [8]
The risk is low that an individual with claudication will develop severe ischemia and require amputation, but the risk of death from coronary events is three to four times higher than matched controls without claudication. [74] Of patients with intermittent claudication, only "7% will undergo lower-extremity bypass surgery, 4% major amputations ...
Patients with PAES are typically healthy young males without previous history of cardiovascular risk factors such as smoking, hypertension, hypercholesterolemia, or diabetes. [13] Typically, patients present with intermittent claudication that is worsened with exercise and relieved with rest. [3]
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The symptoms are caused by ischemia of the tissues. Intermittent claudication is manifested by pain, (cramping), numbness, and fatigue in the muscles on exercise. These symptoms are relieved by rest. There may be “rest pain” at night when in bed. Also increased sensitivity to cold, muscular weakness, stiffness of the joints, and paresthesia .
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