Intermittent venous claudication: a rarely diagnosed walking disability

Intermittent venous claudication occurs mostly in young, physically active people after iliac vein thrombosis. In 20 healthy volunteers and 4 patients with venous claudication, plethysmographic volume measurements of the thigh and calf were made during treadmill work (10 degrees gradient, 7 km/h). The mean volume of the calf in the 20 healthy controls decreased at the beginning of exercise, climbed again later and reached a plateau after 100 sec, indicating a balance between arterial inflow and venous drainage. In the 4 patients with status after iliac vein thrombosis the volume of the affected leg rose continuously during exercise without reaching a plateau, until leg pain forced the patient to stop. The measured volume of the affected leg at the point of pain was higher than that of the patients' contralateral leg and higher than that of the controls (p less than 0.01). Strain-gauge plethysmography during treadmill work permits non-invasive, objective diagnosis of the venous drainage abnormality that leads to intermittent venous claudication.