Percutaneous arterial interventional treatment of exercise-induced neurogenic intermittent claudication due to ischaemia of the lumbosacral plexus.
Radiological interventional therapy is described in seven patients with a distinct clinical syndrome of exercise-induced neurogenic intermittent claudication due to a reversible ischaemia of the lumbosacral plexus during walking accompanied by transient neurologic deficits. This condition was presumably caused by a reversible vascular steal phenomenon during exertion. The underlying vascular conditions were stenoses of the internal and/or common iliac arteries. All patients underwent percutaneous transluminal angioplasty (PTA) during the period from 1988 to 2001; an additional stent was placed in two patients. After a mean follow-up period of 18 months, four patients were asymptomatic, two had an improvement in walking-distance of 300 m and 800 m, respectively, and one patient developed a peripheral intermittent claudication without neurological complaints. In four patients, however, a further intervention was required. In patients with intermittent claudication due to exercise induced ischaemia of the lumbosacral plexus, a successful treatment is possible by means of PTA. Repeat intervention is justified if symptoms recur.
Wohlgemuth
Walter A
WA
Clinic of Diagnostic Radiology and Neuroradiology, Klinikum Augsburg, Germany. w.wohlgemuth@online.de
Stoehr
Manfred
M
D000368:Aged; D000800:Angioplasty, Balloon; D015444:Exercise; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000209:etiology / Q000628:therapy*; D008160:Lumbosacral Plexus; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D020760:Spinal Cord Ischemia / Q000150:complications; D016896:Treatment Outcome