Randomized clinical trial of percutaneous transluminalangioplasty, supervised exercise and combined treatment forintermittent claudication due to femoropopliteal arterial disease

Background:The aim was to compare percutaneous transluminal angioplasty (PTA), a supervisedexercise programme (SEP) and combined treatment (PTA plus SEP) for intermittent claudication dueto femoropopliteal arterial disease.Methods: Consenting patients with femoropopliteal arterial lesions were rando...

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Main Authors:	Mazari, F. A. K., Khan, J. A., Carradice, D., Samuel, N., Abdul Rahman, Mohd Norhisham Azmi, Gulati, S., Lee, H. L. D., McCollum, P. T., Chetter, I. C.
Format:	Article
Language:	English
Published:	Wiley Online Library 2012
Subjects:	RD Surgery
Online Access:	http://irep.iium.edu.my/58418/ http://irep.iium.edu.my/58418/ http://irep.iium.edu.my/58418/ http://irep.iium.edu.my/58418/1/Mazari_et_al-2012-British_Journal_of_Surgery.pdf

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spelling	iium-584182018-01-11T05:54:23Z http://irep.iium.edu.my/58418/ Randomized clinical trial of percutaneous transluminalangioplasty, supervised exercise and combined treatment forintermittent claudication due to femoropopliteal arterial disease Mazari, F. A. K. Khan, J. A. Carradice, D. Samuel, N. Abdul Rahman, Mohd Norhisham Azmi Gulati, S. Lee, H. L. D. McCollum, P. T. Chetter, I. C. RD Surgery Background:The aim was to compare percutaneous transluminal angioplasty (PTA), a supervisedexercise programme (SEP) and combined treatment (PTA plus SEP) for intermittent claudication dueto femoropopliteal arterial disease.Methods: Consenting patients with femoropopliteal arterial lesions were randomized to one of threetreatment arms: PTA, SEP, or PTA plus SEP. All patients received optimal medical treatment. Patientswere assessed at baseline and 1, 3, 6 and 12 months after intervention. Clinical (ankle pressures, walkingdistances, symptoms) and quality-of-life (QoL) outcomes (Short Form 36, VascuQol) were analysed.Results: A total of 178 patients (108 men, median age 70 years) were included. All three treatmentgroups demonstrated significant clinical and QoL improvements. One year after PTA (60 patients, 8withdrew), 37 patients (71 per cent) had improved (16 mild, 16 moderate, 5 marked), nine (17 per cent)showed no improvement and six (12 per cent) had deteriorated. After SEP (60 patients, 14 withdrew),32 patients (70 per cent) had improved (19 mild, 10 moderate, 3 marked), six (13 per cent) showed noimprovement and eight (17 per cent) had deteriorated. After PTA plus SEP (58 patients, 11 withdrew),40 patients (85 per cent) had improved (18 mild, 20 moderate, 2 marked), seven (15 per cent) showedno improvement and none had deteriorated. On intergroup analysis, PTA and SEP alone were equallyeffective in improving clinical outcomes, although the effect was short-lived. PTA plus SEP produced amore sustained clinical improvement, but there was no significant QoL advantage.Conclusion: For patients with intermittent claudication due to femoropopliteal disease, PTA, SEP,and PTA plus SEP were all equally effective in improving walking distance and QoL after 12 months.Registration number: NCT00798850 (http://www.clinicaltrials.gov). Wiley Online Library 2012 Article PeerReviewed application/pdf en http://irep.iium.edu.my/58418/1/Mazari_et_al-2012-British_Journal_of_Surgery.pdf Mazari, F. A. K. and Khan, J. A. and Carradice, D. and Samuel, N. and Abdul Rahman, Mohd Norhisham Azmi and Gulati, S. and Lee, H. L. D. and McCollum, P. T. and Chetter, I. C. (2012) Randomized clinical trial of percutaneous transluminalangioplasty, supervised exercise and combined treatment forintermittent claudication due to femoropopliteal arterial disease. British Journal of Surgery, 99 (1). pp. 39-48. ISSN 1365-2168 http://onlinelibrary.wiley.com/doi/10.1002/bjs.7710/abstract 10.1002/bjs.7710
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English
topic	RD Surgery
spellingShingle	RD Surgery Mazari, F. A. K. Khan, J. A. Carradice, D. Samuel, N. Abdul Rahman, Mohd Norhisham Azmi Gulati, S. Lee, H. L. D. McCollum, P. T. Chetter, I. C. Randomized clinical trial of percutaneous transluminalangioplasty, supervised exercise and combined treatment forintermittent claudication due to femoropopliteal arterial disease
description	Background:The aim was to compare percutaneous transluminal angioplasty (PTA), a supervisedexercise programme (SEP) and combined treatment (PTA plus SEP) for intermittent claudication dueto femoropopliteal arterial disease.Methods: Consenting patients with femoropopliteal arterial lesions were randomized to one of threetreatment arms: PTA, SEP, or PTA plus SEP. All patients received optimal medical treatment. Patientswere assessed at baseline and 1, 3, 6 and 12 months after intervention. Clinical (ankle pressures, walkingdistances, symptoms) and quality-of-life (QoL) outcomes (Short Form 36, VascuQol) were analysed.Results: A total of 178 patients (108 men, median age 70 years) were included. All three treatmentgroups demonstrated significant clinical and QoL improvements. One year after PTA (60 patients, 8withdrew), 37 patients (71 per cent) had improved (16 mild, 16 moderate, 5 marked), nine (17 per cent)showed no improvement and six (12 per cent) had deteriorated. After SEP (60 patients, 14 withdrew),32 patients (70 per cent) had improved (19 mild, 10 moderate, 3 marked), six (13 per cent) showed noimprovement and eight (17 per cent) had deteriorated. After PTA plus SEP (58 patients, 11 withdrew),40 patients (85 per cent) had improved (18 mild, 20 moderate, 2 marked), seven (15 per cent) showedno improvement and none had deteriorated. On intergroup analysis, PTA and SEP alone were equallyeffective in improving clinical outcomes, although the effect was short-lived. PTA plus SEP produced amore sustained clinical improvement, but there was no significant QoL advantage.Conclusion: For patients with intermittent claudication due to femoropopliteal disease, PTA, SEP,and PTA plus SEP were all equally effective in improving walking distance and QoL after 12 months.Registration number: NCT00798850 (http://www.clinicaltrials.gov).
format	Article
author	Mazari, F. A. K. Khan, J. A. Carradice, D. Samuel, N. Abdul Rahman, Mohd Norhisham Azmi Gulati, S. Lee, H. L. D. McCollum, P. T. Chetter, I. C.
author_facet	Mazari, F. A. K. Khan, J. A. Carradice, D. Samuel, N. Abdul Rahman, Mohd Norhisham Azmi Gulati, S. Lee, H. L. D. McCollum, P. T. Chetter, I. C.
author_sort	Mazari, F. A. K.
title	Randomized clinical trial of percutaneous transluminalangioplasty, supervised exercise and combined treatment forintermittent claudication due to femoropopliteal arterial disease
title_short	Randomized clinical trial of percutaneous transluminalangioplasty, supervised exercise and combined treatment forintermittent claudication due to femoropopliteal arterial disease
title_full	Randomized clinical trial of percutaneous transluminalangioplasty, supervised exercise and combined treatment forintermittent claudication due to femoropopliteal arterial disease
title_fullStr	Randomized clinical trial of percutaneous transluminalangioplasty, supervised exercise and combined treatment forintermittent claudication due to femoropopliteal arterial disease
title_full_unstemmed	Randomized clinical trial of percutaneous transluminalangioplasty, supervised exercise and combined treatment forintermittent claudication due to femoropopliteal arterial disease
title_sort	randomized clinical trial of percutaneous transluminalangioplasty, supervised exercise and combined treatment forintermittent claudication due to femoropopliteal arterial disease
publisher	Wiley Online Library
publishDate	2012
url	http://irep.iium.edu.my/58418/ http://irep.iium.edu.my/58418/ http://irep.iium.edu.my/58418/ http://irep.iium.edu.my/58418/1/Mazari_et_al-2012-British_Journal_of_Surgery.pdf
first_indexed	2023-09-18T21:22:36Z
last_indexed	2023-09-18T21:22:36Z
_version_	1777411981925416960

Randomized clinical trial of percutaneous transluminalangioplasty, supervised exercise and combined treatment forintermittent claudication due to femoropopliteal arterial disease

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