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A RCT of non-surgical treatment for intermittent claudication in femoro-popliteal disease: 12-month results

Mazari, Fayyaz Ali Khan and Mehta, Tapan and Abdul Rahman, Mohd Norhisham Azmi and McCollum, Peter Thomas and Chetter, Ian Clifford (2009) A RCT of non-surgical treatment for intermittent claudication in femoro-popliteal disease: 12-month results. British Journal of Surgery, 96 (S1 (January/February)). pp. 10-11. ISSN 0007-1323 E-ISSN 1365-2168

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Objective To compare percutaneous transluminal angioplasty (PTA), a supervised exercise programme (SEP) and combined therapy (PTA + SEP) in the treatment of intermittent claudication (IC) due to femoro‐popliteal disease. Method Over a 6‐year period, 178 patients (108 men, median age 70 years) with angioplastiable femoro‐popliteal lesions were randomised to: PTA, SEP or PTA + SEP. Patients were assessed prior to and at 1, 3 6 and 12 months post‐treatment. ISCVS outcome criteria (ankle pressures, treadmill walking distances) and Quality of Life (QoL) questionnaires (SF‐36 and VascuQoL) were analysed. Results All groups were well matched at baseline. Thirty‐three patients withdrew. Intra‐group analysis: all groups demonstrated significant clinical and QoL improvements (Friedman test, p < 0·05); SEP (59 patients, 13 withdrew) − 69·6% of patients (n = 32) improved following treatment (19 mild, 10 moderate, 3 marked), 13% (n = 6) no improvement and 17·4% (n = 8) deteriorated; PTA (60 patients, 8 withdrew) − 71·2% of patients (n = 37) improved following treatment (16 mild, 16 moderate, 5 marked), 17·3% (n = 9) no improvement and 11·6% (n = 6) deteriorated; PTA + SEP (59 patients, 12 withdrew) − 85·2% of patients (n = 40) improved following treatment (18 mild, 20 moderate, 2 marked), 14·9% (n = 7) no improvement and 0% (n = 0) deteriorated. Inter‐group analysis: PTA + SEP produce a sustained improvement in clinical outcome measures than PTA or SEP alone, but there was no significant QoL advantage (Kruskal Wallis test, p > 0·05). Conclusion For patients with claudication, SEP should be the primary treatment and PTA should be supplemented by a SEP.

Item Type: Article (Meeting Abstract)
Additional Information: 6953/59563
Uncontrolled Keywords: Randomised controlled trial, non-surgical treatment, intermittent claudication, femoro-popliteal disease
Subjects: R Medicine > RD Surgery
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button): Kulliyyah of Medicine
Kulliyyah of Medicine > Department of Surgery
Depositing User: Dr M N A Abdul Rahman
Date Deposited: 05 Oct 2018 10:38
Last Modified: 05 Oct 2018 10:38
URI: http://irep.iium.edu.my/id/eprint/59563

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