ABSTRACT
Claudication is also a symptom of generalised atherosclerosis, and has wider important implications for the patient. Forty per cent of non-diabetic patients who present with intermittent claudication will be dead within 5 years from the associated complications of vascular disease unless preventative treatment is started. Atherosclerosis is extremely common, and occlusive disease can affect most blood vessels. The most important sites, in terms of morbidity and mortality, are the coronary arteries, carotid arteries, arteries of the lower limbs, and the aorta. Chronic lower limb arterial disease due to atherosclerotic occlusive disease is considered. In a critically ischaemic limb, the patient may have developed rest pain, gangrene or ulceration. Skin necrosis produces an ulcer. A cell will die if deprived of oxygen, in a shorter time than the loss of its supply of nutrients, because it has a reserve of the latter. Poorly controlled diabetes is, perhaps, a special case.
