Atherosclerosis and Thrombosis of the Distal Part of the Abdominal Aorta

DR. ALLEN: Partial or complete occlusion of the distal part of the abdominal aorta is characterized clinically by distress produced only by walking and relieved by standing. The amount of walking required to produce distress varies from patient to patient as well as from time to time in the same patient. Characteristically the distress involves the thighs, the regions lateral to the hip joints, the buttocks or, rarely, the distal part of the midlumbar zone. The onset of distress is accelerated when the patient walks up an incline or stairs, or when he walks rapidly. This symptom complex is recognized as intermittent claudication. It differs from that ordinarily noted in association with chronic occlusive arterial diseases involving the legs only in that its location is more proximal; it is commonly designated as "high" intermittent claudication. In rare instances, similar distress is produced in addition by standing or by exercise while standing, such as making beds or scooping grain.