Van der Stricht J
Phlebologie. 1978 Oct-Dec;31(4):425-30.
The intermittent claudication is a symptom. By itself, it does not justify surgical treatment. On the other hand, it is advisable when accompanied by a threat of trophic disorders. Direct arterial surgery is often necessary in the case of suprainguinal, aorto-iliac lesion, rarely in the leg. Indeed, under the inguinal area, nature tends to compensate for occlusions of the trunk by the formation of a parallel network. A logical treatment is to contribute to this tendency, by increasing the upward and downward pressure gradient through muscular exercise and lumbar sympathectomy. In practice, the choice between hyperemia surgery and reconstructive surgery rests on functional data, that make it possible to evaluate the potential of the parallel network and of the peripheral vascular bed.
间歇性跛行是一种症状。就其本身而言,它并不足以成为手术治疗的理由。另一方面,当伴有营养障碍的威胁时,手术治疗是可取的。对于腹股沟以上的腹主动脉-髂动脉病变,直接动脉手术通常是必要的,而在腿部则很少需要。实际上,在腹股沟区域以下,机体往往会通过形成平行网络来代偿主干血管的闭塞。一种合理的治疗方法是通过肌肉锻炼和腰交感神经切除术增加上下压力梯度,以促进这种代偿倾向。在实际操作中,充血手术和重建手术之间的选择取决于功能数据,这些数据能够评估平行网络和外周血管床的潜力。