Prognosis and Duration of disabling effects

A five year review of patients with claudication has shown that:

• About 75% remain stable or have an improvement in symptoms. These people need to be reviewed, as they may not have disabling effects
• 20% develop worsening claudication
• 5% develop critical ischaemia
• 1% undergo limb amputation

A person with PVD has a six to seven time’s greater risk of coronary artery disease, heart attack, stroke, or transient ischaemic attack (mini- stroke) than the rest of the population. If a person has heart disease, he/she has a 1 in 3 chance of having blocked arteries in the legs. (Reference: NHLBI US Department of Health & Human Services)

It also depends on what has caused the PVD in the first place:

• Treatment of a single cause (such as an embolus) normally gives good results.
• A supervised exercise regime in persons with chronic lower limb ischaemia, due to generalised arteriosclerosis definitely improves claudication distance.
• Worsening, severe ischaemia in the lower limbs treated with angioplasty or bypass grafting (CABG) produces good results.
• The annual mortality rate of persons with intermittent claudication is greater than 5% (which is 2 to 3 times higher than the “normal” population.
• The annual mortality rate of those with severe disease (severe critical ischaemia) is 25% (mostly from other cardiovascular events such as heart attack or stroke).

If awaiting surgery (Angioplasty or CABG) - 1 year award

If no surgery is planned – indefinite award

All information must be taken into account when considering the duration of disabling effects and the duration of disabling effects must be based on the particular circumstances of the individual claimant.

Amended April 2008