Intermittent Claudication Service UHCW

The clinic assesses and treats patients with symptoms of Peripheral Arterial Disease (PAD) :

• Reproducible exertional muscle pain typically affecting the calf.
• Pain feels crampy in nature, is worse on walking uphill and is relieved with a short rest of <10 minutes.

The clinic assessment provides:

• Patients Education: risk factor management and assists / supports the patient to make lifestyle changes.
• Best Medical Therapy of anti-platelet therapy, preferably Clopidogrel, and statin therapy (secondary prevention).
• Referral to Supervised Exercise Programme (SEP) as per NICE guidelines. Patients can access 24 NHS funded SEP sessions at Atrium Health in Coventry City Centre or at Cardiac Rehabilitation Department at Rugby St Cross.  SEP is ran by both a vascular specialist nurse and a clinical exercise physiologist with exercise being adapted to suit most patients needs.

Pre Referral

Please consider FBC, U&Es, LFTs, Cholesterol and HbA1C checks prior to referral.

The Intermittent Claudication Service is a nurse-led service, consultants will not see claudication referrals without a nurse assessment in the first instance.

Referrals sent to a consultant clinic will be redirected to the nurse-led claudication clinic.

Exclusions:

The clinic does not see patients with the following critical symptoms (referrals should be directed to consultant arterial clinics for urgent assessment):

• Ulcers
• Toe or foot pain reproducible on elevation which is relieved with dependency
• Necrosis
• Gangrene

The clinic does not see patients aged ≤30 years old as popliteal entrapment syndrome needs to be excluded by vascular consultants.

The clinic does not see patients who require ABPI measurements alone.  Please refer directly to the Vascular Laboratory.

Critical Ischaemia (Peripheral Arterial Disease – Critical)

Urgent referrals ONLY to be referred to the Consultant Clinic (Peripheral Arterial Disease Critical – Consultant Clinic – Ischaemic).

Exclusions:

The Peripheral Arterial Disease Critical Clinic should not receive referrals for:-

• Cold feet without rest pain or tissue loss
• Absent foot pulses without rest pain or tissue loss
• Swollen feet without rest pain or tissue loss
• Lymphoedema (please see GP Gateway Lymphoedema page – follow link)

Advice & Guidance can be used for management advice of these excluded conditions.