Percutaneous arterial interventional treatment of exercise-induced neurogenic intermittent claudication due to ischaemia of the lumbosacral plexus

Abstract

Radiological interventional therapy is described in seven patients with a distinct clinical syndrome of exercise-induced neurogenic intermittent claudication due to a reversible ischaemia of the lumbosacral plexus during walking accompanied by transient neurologic deficits. This condition was presumably caused by a reversible vascular steal phenomenon during exertion. The underlying vascular conditions were stenoses of the internal and/or common iliac arteries. All patients underwent percutaneous transluminal angioplasty (PTA) during the period from 1988 to 2001; an additional stent was placed in two patients. After a mean follow-up period of 18 months, four patients were asymptomatic, two had an improvement in walking-distance of 300 m and 800 m, respectively, and one patient developed a peripheral intermittent claudication without neurological complaints. In four patients, however, a further intervention was required. In patients with intermittent claudication due to exercise induced ischaemia of the lumbosacral plexus, a successful treatment is possible by means of PTA. Repeat intervention is justified if symptoms recur.