This resulted in relief of the rest pain
and healing of the ischaemic leg ulcer.
Stage Symptoms 1 Asymptomatic (without symptoms) 2 Intermittent Claudication 3 Ischaemic rest pain
4 Severe rest pain
with ulceration or gangrene or both.
was present as a primary feature in all the patients (100%), while tissue loss or gangrene was seen in 22 (73.
One reason for this is that even without epidural analgesia, rest pain
is quite low after major surgery (median VAS 1 cm, interquartile range [0 to 3] at 24 hours in the MASTER trial), so any improvement is perforce modest.
Chief symptoms were intermittent claudication, rest pain
, gangrene of toes and ulceration at tip of toes or foot (Table 2).
The age and VAS rest pain
were significantly higher in the rupture group than in the without-rupture group (p<0.
5 and 7 year mortality rates in patients with rest pain
can be as high as 60% and 70%, respectively (8).
Patients with CLI have ankle pressures below 50 mmHg and/or toe pressures below 30 mmHg, ischaemic rest pain
and/or tissue necrosis (skin ulcer or gangrene).
Although there was neither rest pain
nor sensory disturbance, tenderness was detected at the supraclavicular fossa.
Patients were excluded if any of the following were present: absence of PAD; rest pain
or tissue loss; limitations of exercise tolerance caused by conditions other than claudication (e.
Patients with PAD are really a category of patients with a very high cardiovascular risk burden for fatal and nonfatal cerebrovascular and cardiovascular events; therefore, they need to be treated not only for local problems deriving from arteriopathy (intermittent claudication, rest pain
and/or ulcers) but, above all, for preventing vascular events.
The primary endpoints, improvement of rest pain
(Visual Analog Scale, or VAS) or ischemic ulcer size, at 12 weeks post dosing, showed 30.