Arterial Surgery in Intermittent Claudication

The results of a survey of 302 operations in 277 patients during 1959-70 are presented, and an additional 69 operations during 1971 are included in the mortality figures. Operative mortality (1968-71) was 0·9% in 113 aortoiliac operations and nil in 96 femoropopliteal operations.Immediate patency rates on dismissal from hospital exceeded 95%, and the five-year patency rate for aortoiliac operations was just over 70% and for femoropopliteal operations 60%.     

Place of Achilles Tenotomy in the Treatment of Severe Intermittent Claudication

Achilles tenotomy was performed on 66 limbs in 60 patients with severe intermittent claudication and the results were assessed two years later. Early improvement occurred in half of them but decreased to 17% two years postoperatively. Sympathectomy did not influence the result. The postoperative morbidity was 14%, and 21% of limbs were subsequently amputated. The late mortality in the group studied was 8%.     

Effect of Clofibrate on Blood Viscosity in Intermittent Claudication

Sixty-two patients with intermittent claudication associated with peripheral arterial diseases were treated with clofibrate, 2 g daily, for a minimum of six months. Progress was compared with that in a similar pretreatment period and also with that of a matched untreated control group of 27 patients. The most striking effect of clofibrate was a steep and sustained fall in whole-blood viscosity measured over a wide range of shear rates. This was associated with a significant fall in abnormally raised initial plasma-fibrinogen levels. An increased proportion of patients on treatment showed evidence of clinical improvement. Clofibrate had no effect on the susceptibility of red blood cells to autoxidation but it led to a significant shift in the red cell fatty acid pattern.