Literature DB >> 19762206

Early outcomes from a randomized, controlled trial of supervised exercise, angioplasty, and combined therapy in intermittent claudication.

F A K Mazari1, S Gulati, M N A Rahman, H L D Lee, T A Mehta, P T McCollum, I C Chetter.   

Abstract

BACKGROUND: To compare angioplasty (PTA), supervised exercise (SEP) and PTA + SEP in the treatment of intermittent claudication (IC) due to femoropopliteal disease.
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.
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).
CONCLUSION: SEP should be the primary treatment for the patients with claudication and PTA should be supplemented by an SEP. Copyright 2010 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.

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Year:  2009        PMID: 19762206     DOI: 10.1016/j.avsg.2009.07.005

Source DB:  PubMed          Journal:  Ann Vasc Surg        ISSN: 0890-5096            Impact factor:   1.466


  13 in total

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Authors:  Marie D Gerhard-Herman; Heather L Gornik; Coletta Barrett; Neal R Barshes; Matthew A Corriere; Douglas E Drachman; Lee A Fleisher; Francis Gerry R Fowkes; Naomi M Hamburg; Scott Kinlay; Robert Lookstein; Sanjay Misra; Leila Mureebe; Jeffrey W Olin; Rajan A G Patel; Judith G Regensteiner; Andres Schanzer; Mehdi H Shishehbor; Kerry J Stewart; Diane Treat-Jacobson; M Eileen Walsh
Journal:  Circulation       Date:  2016-11-13       Impact factor: 29.690

Review 2.  Combined Lower Limb Revascularisation and Supervised Exercise Training for Patients with Peripheral Arterial Disease: A Systematic Review of Randomised Controlled Trials.

Authors:  Annelise L Menêses; Raphael M Ritti-Dias; Belinda Parmenter; Jonathan Golledge; Christopher D Askew
Journal:  Sports Med       Date:  2017-05       Impact factor: 11.136

3.  Asia-Pacific Consensus Statement on the Management of Peripheral Artery Disease: A Report from the Asian Pacific Society of Atherosclerosis and Vascular Disease Asia-Pacific Peripheral Artery Disease Consensus Statement Project Committee.

Authors:  Maria Teresa B Abola; Jonathan Golledge; Tetsuro Miyata; Seung-Woon Rha; Bryan P Yan; Timothy C Dy; Marie Simonette V Ganzon; Pankaj Kumar Handa; Salim Harris; Jiang Zhisheng; Ramakrishna Pinjala; Peter Ashley Robless; Hiroyoshi Yokoi; Elaine B Alajar; April Ann Bermudez-Delos Santos; Elmer Jasper B Llanes; Gay Marjorie Obrado-Nabablit; Noemi S Pestaño; Felix Eduardo Punzalan; Bernadette Tumanan-Mendoza
Journal:  J Atheroscler Thromb       Date:  2020-07-04       Impact factor: 4.928

Review 4.  Assessment of functional status and quality of life in claudication.

Authors:  Ryan J Mays; Ivan P Casserly; Wendy M Kohrt; P Michael Ho; William R Hiatt; Mark R Nehler; Judith G Regensteiner
Journal:  J Vasc Surg       Date:  2011-02-18       Impact factor: 4.268

5.  Predicting functional status following amputation after lower extremity bypass.

Authors:  Bjoern D Suckow; Philip P Goodney; Robert A Cambria; Daniel J Bertges; Jens Eldrup-Jorgensen; Jeffrey E Indes; Andres Schanzer; David H Stone; Larry W Kraiss; Jack L Cronenwett
Journal:  Ann Vasc Surg       Date:  2012-01       Impact factor: 1.466

6.  Supervised exercise versus primary stenting for claudication resulting from aortoiliac peripheral artery disease: six-month outcomes from the claudication: exercise versus endoluminal revascularization (CLEVER) study.

Authors:  Timothy P Murphy; Donald E Cutlip; Judith G Regensteiner; Emile R Mohler; David J Cohen; Matthew R Reynolds; Joseph M Massaro; Beth A Lewis; Joselyn Cerezo; Niki C Oldenburg; Claudia C Thum; Suzanne Goldberg; Michael R Jaff; Michael W Steffes; Anthony J Comerota; Jonathan Ehrman; Diane Treat-Jacobson; M Eileen Walsh; Tracie Collins; Dalynn T Badenhop; Ulf Bronas; Alan T Hirsch
Journal:  Circulation       Date:  2011-11-16       Impact factor: 29.690

7.  Comparative effectiveness study of self-directed walking exercise, lower extremity revascularization, and functional decline in peripheral artery disease.

Authors:  Mary M McDermott; Melina Kibbe; Jack M Guralnik; William H Pearce; Lu Tian; Yihua Liao; Lihui Zhao; Michael H Criqui
Journal:  J Vasc Surg       Date:  2013-01-24       Impact factor: 4.268

Review 8.  Exercise training and peripheral arterial disease.

Authors:  Tara L Haas; Pamela G Lloyd; Hsiao-Tung Yang; Ronald L Terjung
Journal:  Compr Physiol       Date:  2012-10       Impact factor: 9.090

Review 9.  Endovascular revascularisation versus conservative management for intermittent claudication.

Authors:  Farzin Fakhry; Hugo Jp Fokkenrood; Sandra Spronk; Joep Aw Teijink; Ellen V Rouwet; M G Myriam Hunink
Journal:  Cochrane Database Syst Rev       Date:  2018-03-08

Review 10.  Exercise for intermittent claudication.

Authors:  Risha Lane; Amy Harwood; Lorna Watson; Gillian C Leng
Journal:  Cochrane Database Syst Rev       Date:  2017-12-26
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