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

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) w...

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Main Authors:	Mazari, Fayyaz Ali Khan, Mehta, Tapan, Abdul Rahman, Mohd Norhisham Azmi, McCollum, Peter Thomas, Chetter, Ian Clifford
Format:	Article
Language:	English
Published:	Wiley 2009
Subjects:	RD Surgery
Online Access:	http://irep.iium.edu.my/59563/ http://irep.iium.edu.my/59563/ http://irep.iium.edu.my/59563/ http://irep.iium.edu.my/59563/1/British%20Journal%20of%20Surgery%202009%2C96%28S1%29%2C%201-15.pdf

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spelling	iium-595632018-10-05T02:38:05Z http://irep.iium.edu.my/59563/ A RCT of non-surgical treatment for intermittent claudication in femoro-popliteal disease: 12-month results Mazari, Fayyaz Ali Khan Mehta, Tapan Abdul Rahman, Mohd Norhisham Azmi McCollum, Peter Thomas Chetter, Ian Clifford RD Surgery 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. Wiley 2009-01 Article PeerReviewed application/pdf en http://irep.iium.edu.my/59563/1/British%20Journal%20of%20Surgery%202009%2C96%28S1%29%2C%201-15.pdf 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 https://onlinelibrary.wiley.com/doi/full/10.1002/bjs.6528 10.1002/bjs.6528
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, Fayyaz Ali Khan Mehta, Tapan Abdul Rahman, Mohd Norhisham Azmi McCollum, Peter Thomas Chetter, Ian Clifford A RCT of non-surgical treatment for intermittent claudication in femoro-popliteal disease: 12-month results
description	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.
format	Article
author	Mazari, Fayyaz Ali Khan Mehta, Tapan Abdul Rahman, Mohd Norhisham Azmi McCollum, Peter Thomas Chetter, Ian Clifford
author_facet	Mazari, Fayyaz Ali Khan Mehta, Tapan Abdul Rahman, Mohd Norhisham Azmi McCollum, Peter Thomas Chetter, Ian Clifford
author_sort	Mazari, Fayyaz Ali Khan
title	A RCT of non-surgical treatment for intermittent claudication in femoro-popliteal disease: 12-month results
title_short	A RCT of non-surgical treatment for intermittent claudication in femoro-popliteal disease: 12-month results
title_full	A RCT of non-surgical treatment for intermittent claudication in femoro-popliteal disease: 12-month results
title_fullStr	A RCT of non-surgical treatment for intermittent claudication in femoro-popliteal disease: 12-month results
title_full_unstemmed	A RCT of non-surgical treatment for intermittent claudication in femoro-popliteal disease: 12-month results
title_sort	rct of non-surgical treatment for intermittent claudication in femoro-popliteal disease: 12-month results
publisher	Wiley
publishDate	2009
url	http://irep.iium.edu.my/59563/ http://irep.iium.edu.my/59563/ http://irep.iium.edu.my/59563/ http://irep.iium.edu.my/59563/1/British%20Journal%20of%20Surgery%202009%2C96%28S1%29%2C%201-15.pdf
first_indexed	2023-09-18T21:24:23Z
last_indexed	2023-09-18T21:24:23Z
_version_	1777412094054891520

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

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