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Early outcomes from a randomized, controlled trial of supervised exercise, angioplasty, and combined therapy in intermittent claudication.
- Source :
-
Annals of vascular surgery [Ann Vasc Surg] 2010 Jan; Vol. 24 (1), pp. 69-79. Date of Electronic Publication: 2009 Sep 17. - Publication Year :
- 2010
-
Abstract
- Background: To compare angioplasty (PTA), supervised exercise (SEP) and PTA + SEP in the treatment of intermittent claudication (IC) due to femoropopliteal disease.<br />Methods: Over a 6-year period, 178 patients (108 men; median age, 70 years) with femoropopliteal lesions suitable for angioplasty were randomized to PTA, SEP, or PTA + SEP. Patients were assessed prior to and at 1 and 3 months post treatment. ISCVS outcome criteria (ankle pressures, treadmill walking distances) and quality of life (QoL) questionnaires (SF-36 and VascuQoL) were analyzed.<br />Results: All groups were well matched at baseline. Twenty-one patients withdrew. Results are as follows: Intragroup analysis: All groups demonstrated significant clinical and QoL improvements (Friedman test, p < 0.05). SEP (60 patients, 8 withdrew)-62.7% of patients (n = 32) improved following treatment [20 mild, 9 moderate, 3 marked], 27.4% (n = 14) demonstrated no improvement, and 9.8% (n = 5) deteriorated. PTA (60 patients, 3 withdrew)-66.6% patients (n = 38) improved following treatment [19 mild, 10 moderate, 9 marked], 22.8% (n = 13) demonstrated no improvement, and 10.5% (n = 6) deteriorated. PTA + SEP (58 patients, 10 withdrew)-81.6% of patients (n = 40) improved following treatment [10 mild, 17 moderate, 3 marked], 14.2% (n = 7) demonstrated no improvement, and 4.0% (n = 2) deteriorated. Intergroup analysis: PTA + SEP produce a much greater improvement in clinical outcome measures than PTA or SEP alone, but there was no significant QoL advantage (Kruskal-Wallis test, p > 0.05).<br />Conclusion: SEP should be the primary treatment for the patients with claudication and PTA should be supplemented by an SEP.<br /> (Copyright 2010 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Ankle blood supply
Arterial Occlusive Diseases complications
Arterial Occlusive Diseases physiopathology
Arterial Occlusive Diseases psychology
Blood Pressure
Combined Modality Therapy
Exercise Test
Exercise Tolerance
Female
Humans
Intermittent Claudication etiology
Intermittent Claudication physiopathology
Intermittent Claudication psychology
Male
Middle Aged
Prospective Studies
Quality of Life
Recovery of Function
Surveys and Questionnaires
Time Factors
Treatment Outcome
Walking
Angioplasty, Balloon
Arterial Occlusive Diseases therapy
Exercise Therapy
Femoral Artery physiopathology
Intermittent Claudication therapy
Popliteal Artery physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1615-5947
- Volume :
- 24
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Annals of vascular surgery
- Publication Type :
- Academic Journal
- Accession number :
- 19762206
- Full Text :
- https://doi.org/10.1016/j.avsg.2009.07.005