scholarly journals Comparative Efficacy of Endovascular Revascularization Versus Supervised Exercise Training in Patients With Intermittent Claudication

2017 ◽  
Vol 10 (7) ◽  
pp. 712-724 ◽  
Author(s):  
Ambarish Pandey ◽  
Subhash Banerjee ◽  
Christian Ngo ◽  
Purav Mody ◽  
Steven P. Marso ◽  
...  
Keyword(s):  
Exercise Training ◽  
Intermittent Claudication ◽  
Comparative Efficacy ◽  
Supervised Exercise ◽  
Endovascular Revascularization

Abstract 19720: Jay D. Coffman Early Career Investigator Award: Comparative Efficacy of Initial Endovascular Revascularization vs. Supervised Exercise Training in Patients With Intermittent Claudication: A Meta-analysis of Randomized Controlled Trials

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Ambarish Pandey ◽  
Subhash Banerjee ◽  
Christian Ngo ◽  
Purav Mody ◽  
Steven Marso ◽  
...  
Keyword(s):  
Exercise Training ◽  
Randomized Controlled Trials ◽  
Intermittent Claudication ◽  
Meta Analysis ◽  
Walking Distance ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Supervised Exercise ◽  
Endovascular Revascularization

Introduction: Current guidelines recommend supervised exercise training (SET) as the initial treatment modality for patients with intermittent claudication (IC), in addition to optimal medical therapy. The role of endovascular revascularization (ER) as a primary treatment option has been controversial. We performed a meta-analysis to compare the efficacy of initial ER vs. initial SET in patients with IC using data from randomized controlled trials. Methods: The primary outcome was treadmill-measured maximum walking distance (MWD) at the end of follow-up. Secondary outcomes included resting ankle brachial index (ABI) and treadmill-measured ischemic claudication distance (ICD) on follow-up. Risk of adverse limb events (revascularization, amputations) was also compared between the two groups. Random effects models were used for all analyses. Results: We included 1,145 patients from nine trials with a mean follow up duration of 13.7 months (42% aortoiliac lesions; 35% stent use; mean baseline ABI 0.64 vs. 0.67 for ER vs. SET). Follow-up MWD was not significantly different between patients undergoing ER vs. SET [Weighted mean difference (WMD) (95% CI): 19.1 m (-79.6 to 117.8 m); publication bias p=0.86]. Metaregression did not identify significant differences based on stent use or presence of aortoiliac disease. ICD was also similar between the two groups [WMD (95% CI): 36.1 m (-99.4 to 171.5 m)]. In contrast, patients undergoing ER had higher resting ABI on follow-up [WMD (95% CI): 0.14 (0.11 to 0.17), p<0.0001]. Adverse limb event rates were similar [5.4% vs. 8.2%, p=0.21]. Conclusion: Compared with initial SET, initial ER significantly improves resting ABI values. Although longer walking distance and lower rates of adverse limb events also appeared favorable for ER, these differences were not statistically significant in these intermediate term studies. Longer-term studies and those incorporating contemporary revascularization techniques are necessary.

scholarly journals Supervised Exercise Training for Intermittent Claudication: Lasting Benefit at Three Years

2007 ◽  
Vol 34 (3) ◽  
pp. 322-326 ◽  
Author(s):  
D.A. Ratliff ◽  
M. Puttick ◽  
G. Libertiny ◽  
R.C.J. Hicks ◽  
L.E. Earby ◽  
...  
Keyword(s):  
Exercise Training ◽  
Intermittent Claudication ◽  
Supervised Exercise

scholarly journals Supervised Exercise Training for Intermittent Claudication: Lasting Benefit at Three Years

2007 ◽  
Vol 46 (3) ◽  
pp. 611
Author(s):  
D.A. Ratliff ◽  
M. Puttick ◽  
G. Libertiny ◽  
R.C.J. Hicks ◽  
L.E. Earby ◽  
...  
Keyword(s):  
Exercise Training ◽  
Intermittent Claudication ◽  
Supervised Exercise
Sign in / Sign up

Export Citation Format

Share Document