It is difficult, despite great advances in arterial surgery, to assess the relationship of intermittent claudication to the degree of ischemia which exists in the lower limbs of patients following complete or partial arterial occlusion by arteriosclerotic changes. The impairment of the actual muscular blood flow in the affected muscles is impossible to assess, although various techniques—such as plethysmography–can give the changes in the blood flow which occur in the whole leg, but the relative increase in the flow in the muscles, as compared with the increase in peripheral circulation following exercise, cannot be estimated. Histologic and radiographic investigations on postmortem and amputated limbs suggest that the smaller muscular branches may or may not be involved to the same degree as the larger vessels in arteriosclerosis. It is the caliber of the muscular branches which determines the blood flow to the muscles. Any operative procedure undertaken to improve intermittent
GRIFFITHS JD, DE TAKATS G, FROST J. Intermittent Claudication Studied by Electromyography. AMA Arch Surg. 1960;81(1):94–102. doi:10.1001/archsurg.1960.01300010096018
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