- Katkokävely on kroonisen alaraajaiskemian yleisin kliininen ilmenemismuoto: katkokävelyä sairastaa 1-7 % yli 55-vuotiaista. Suomessa ongelmasta kärsii noin 100 000 ihmistä.

- Taustalla on yleensä valtimonkovettumistauti eli arterioskleroosi.

- Krooninen alaraajaiskemia, sepelvaltimotauti ja aivoverenkiertohäiriöt esiintyvät monesti yhtä aikaa. Tämän takia katkokävelypotilaan kokonaisennuste on kohtalaisen huono.

- Katkokävelyn diagnoosi perustuu tyypilliseen anamneesiin, kliiniseen tutkimukseen ja

I-mittaukseen.

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- Katkokävelyä tulisi hoitaa pääasiassa konservatiivisesti.

- Toimenpiteellisiä hoitoja harkitaan, jos vaiva rajoittaa merkittävästi potilaan selviytymistä omassa toimintaympäristössään.

Peripheral arterial disease (PAD) is defined as a narrowing or occlusion of the arteries supplying the lower extremities. PAD is a common but underdiagnosed and undertreated disorder with substantial morbidity and mortality. The major cause of PAD is atherosclerosis. Consequently, the pathophysiology and the risk factors for developing PAD are similar to those for atherosclerotic disease occurring at other sites. The overall prevalence of PAD is in the range of 3% to 18%, increasing to 30% in persons over 75 years. These figures also include patients who are asymptomatic but have a diminished ankle-brachial index (

I). Only roughly one third of PAD patients exhibit typical symptoms of intermittent claudication.

PAD, regardless of the symptoms, has been associated with increased cardiovascular morbidity and mortality. The prognosis of intermittent claudication (IC) regarding the leg is good. Only some 5%-10% of the patients will develop critical limb ischaemia (CLI) during the first five years after the diagnosis, and only 1%-2% will ever require major amputation. At the same time, the fate of the patient is considerably worse due to the systemic character of atherosclerosis. It has been estimated that approximately 20% of the patients with IC die within five years of the diagnosis from myocardial infarction or stroke; another 5%-10% will suffer nonfatal cardiovascular events.

The diagnosis of PAD should be based on a complete medical history, a physical examination and objective testing. A resting

I of