Proper advice to the patient with symptomatic arterial insufficiency of the leg due to atherosclerosis depends upon a thorough understanding of the natural history of this disease and adequate knowledge of those therapeutic maneuvers which are likely to improve its course. Prior to making specific recommendations for therapy, however, the physician first must determine whether there has been significant disruption of the patient's personality, his job, and his daily activity. Only after this judgment is made can treatment most appropriate for the particular patient's needs be applied.
Before reviewing the available methods of therapy, several brief generalizations summarizing current knowledge of the natural history of peripheral atherosclerosis may be pertinent.1Significant coronary and cerebrovascular arterial disease usually is present in patients with intermittent claudication. The prognosis for life in this group is, in great part, determined by these lesions and consequently is considerably worse than that for