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January 19, 1957


Author Affiliations

Professor of Surgery, Duke University School of Medicine, Durham, N. C.

JAMA. 1957;163(3):186-188. doi:10.1001/jama.1957.02970380028008

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As average life expectancy increases, physicians are more frequently confronted with patients describing intermittent claudication caused by arteriosclerosis. A decision must be made as to whether medical management is to be used alone or is to be supplemented by a sympathectomy or an arterial replacement or bridge. Systemic atherosclerosis causes a variety of complications, including cerebrovascular accidents, coronary occlusions, renal failure, and mesenteric thrombosis. These are pertinent to this editorial only as usual causes of death. Occlusion of the lower part of the aorta or its iliac and femoral branches ordinarily is a less serious event in the disease process. Patients in whom intermittent claudication develops should receive medical treatment for systemic atherosclerosis. This includes advice with regard to regulation of exercise and limitation of weight. Also, according to present evidence, it should include a strict low-fat diet, supplemented if necessary by ingestion of sitosterols (Cytellin). Diabetes, if present, must

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