Untersuchung zur Beurteilung des präoperativen Behandlungsverlaufs und der postoperativen Entwicklung mit beruflicher Reintegration bei Patienten mit atypischer Claudicatio

Nowadays the incidence of peripheral arterial occlusive disease is increasing. 95 % are due to arteriosclerotic changes in the arteries. The remaining 5 % are combines in the generic term of “atypical claudication”. Of major concern are here the popliteal arterial entrapment syndrome (paes) and the cystic adventitia disease (cad). In opposite to the arteriosclerotic genesis of paod this two entities are localised and not systemic diseases. That makes a curative treatment possible. For this study all consecutive patients of the surgical department of the university of Marburg of the years 2003 and 2004 were screened and patients with the main-diagnosis of popliteal arterial entrapment syndrome or cystical adventitia disease called and invited to a reevaluation. Seven of eight patients joint the survey. Striking in all cases is the long time from the start of the complaints until the finding of the rigt diagnosis of “atypical claudication”. In course of the history of the complaints the patients visited on average four different specialties until the right diagnosis was found. Once the diagnosis of popliteal arterial entrapment syndrome or cystical adventitia degeneration was found and surgical therapy initiated a curative treatment is rapidly possible. The surgical treatment is nowadays a standard operation and the postoperative days in hospital were on average eight days. Five of the seven patients described a total loss of complaints and a reestablishment of former physical activity. The two patients still under employment were reintegrated in their jobs seven days after admission of the hospital. In the Reevaluation all patients described a lasting effect of the surgical therapy and no recurrence of the formaly complaint symptoms. This shows a restituti ad integrum was established. In summary of this survey the diagnosis of “atypical claudication” is in the prescribed cases hard to detect. Once the right diagnosis is found a lasting surgical therapy is possible due to the strongly localised event. This surgical intervention is nowadays a standard operation without a high perioperativ risk. With this study we want to emphasize the importance of “atypical claudication” and create a further awareness of this disease, which is easy and curative treatable.