Comparison of the long-term results between surgical and conservative treatment in patients with intermittent claudication.
BACKGROUND
The optional therapeutic strategy for patients with intermittent claudication remains controversial. In this study, we investigated the influence of surgical and conservative therapies on improving the quality of life in patients with intermittent claudication.


METHODS
We analyzed 427 patients who were admitted to our hospital with intermittent claudication in their legs during a 15-year period from January 1984 to December 1999. We separated them into 2 groups; 259 patients (362 legs) were treated surgically and 168 patients were treated conservatively.


RESULTS
At the suprainguinal and infrainguinal (above knee) region, the surgery group showed significantly better rate of improvement than did the conservative group, but in the infrainguinal (below knee) region, there was no significant difference between the 2 groups. The 3-year and 5-year patency rates for the arterial reconstruction of the suprainguinal and infrainguinal region was satisfactory, but that of the infrainguinal region was not very good even if an auto vein graft was used.


CONCLUSIONS
Aggressive surgical treatment is therefore recommended in patients whose distal anastomotic region is above the knee, because there are great benefits from surgical reconstruction. However, in patients whose distal anastomotic region is below the knee, conservative treatment might be just as effective as surgery.
Mori
Emiko
E
Department of Surgery and Science, Kyushu University, Graduate School of Medical Sciences, Fukuoka, Japan.
Komori
Kimihiro
K
Kume
Masazumi
M
Yamaoka
Terutoshi
T
Shoji
Tetsuya
T
Furuyama
Tadashi
T
Inoguchi
Hiroyuki
H
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000453:epidemiology; D006801:Humans; D007383:Intermittent Claudication / Q000453:epidemiology / Q000601:surgery* / Q000628:therapy*; D007717:Knee; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome