Early outcomes from a randomized, controlled trial of supervised exercise, angioplasty, and combined therapy in intermittent claudication
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 we...
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iium-592452017-11-10T02:21:28Z http://irep.iium.edu.my/59245/ Early outcomes from a randomized, controlled trial of supervised exercise, angioplasty, and combined therapy in intermittent claudication Mazari, Fayyaz Ali Khan Gulati, Sumit M. Abdul Rahman, Mohd Norhisham Azmi Lee, H L Mehta, Tapan Anil McCollum, Peter Thomas Chetter, Ian Clifford RD Surgery 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. Elsevier 2010-01 Article PeerReviewed application/pdf en http://irep.iium.edu.my/59245/1/Early%20outcomes%20from%20a%20randomized%2C%20controlled%20trial%20of%20supervised%20exercise%2C%20angioplasty%2C%20and%20combined%20therapy%20in%20intermittent%20claudication.pdf Mazari, Fayyaz Ali Khan and Gulati, Sumit M. and Abdul Rahman, Mohd Norhisham Azmi and Lee, H L and Mehta, Tapan Anil and McCollum, Peter Thomas and Chetter, Ian Clifford (2010) Early outcomes from a randomized, controlled trial of supervised exercise, angioplasty, and combined therapy in intermittent claudication. Annals of Vascular Surgery, 24 (1). pp. 69-79. ISSN 0890-5096 E-ISSN 1615-5947 http://www.annalsofvascularsurgery.com/article/S0890-5096(09)00167-8/abstract 10.1016/j.avsg.2009.07.005 |
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RD Surgery Mazari, Fayyaz Ali Khan Gulati, Sumit M. Abdul Rahman, Mohd Norhisham Azmi Lee, H L Mehta, Tapan Anil McCollum, Peter Thomas Chetter, Ian Clifford Early outcomes from a randomized, controlled trial of supervised exercise, angioplasty, and combined therapy in intermittent claudication |
description |
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. |
format |
Article |
author |
Mazari, Fayyaz Ali Khan Gulati, Sumit M. Abdul Rahman, Mohd Norhisham Azmi Lee, H L Mehta, Tapan Anil McCollum, Peter Thomas Chetter, Ian Clifford |
author_facet |
Mazari, Fayyaz Ali Khan Gulati, Sumit M. Abdul Rahman, Mohd Norhisham Azmi Lee, H L Mehta, Tapan Anil McCollum, Peter Thomas Chetter, Ian Clifford |
author_sort |
Mazari, Fayyaz Ali Khan |
title |
Early outcomes from a randomized, controlled trial of supervised exercise, angioplasty, and combined therapy in intermittent claudication |
title_short |
Early outcomes from a randomized, controlled trial of supervised exercise, angioplasty, and combined therapy in intermittent claudication |
title_full |
Early outcomes from a randomized, controlled trial of supervised exercise, angioplasty, and combined therapy in intermittent claudication |
title_fullStr |
Early outcomes from a randomized, controlled trial of supervised exercise, angioplasty, and combined therapy in intermittent claudication |
title_full_unstemmed |
Early outcomes from a randomized, controlled trial of supervised exercise, angioplasty, and combined therapy in intermittent claudication |
title_sort |
early outcomes from a randomized, controlled trial of supervised exercise, angioplasty, and combined therapy in intermittent claudication |
publisher |
Elsevier |
publishDate |
2010 |
url |
http://irep.iium.edu.my/59245/ http://irep.iium.edu.my/59245/ http://irep.iium.edu.my/59245/ http://irep.iium.edu.my/59245/1/Early%20outcomes%20from%20a%20randomized%2C%20controlled%20trial%20of%20supervised%20exercise%2C%20angioplasty%2C%20and%20combined%20therapy%20in%20intermittent%20claudication.pdf |
first_indexed |
2023-09-18T21:23:54Z |
last_indexed |
2023-09-18T21:23:54Z |
_version_ |
1777412063503581184 |