title: Quality of life and functional status after revascularization or conservative treatment in patients with intermittent claudication.
abstract: Revascularization of patients with intermittent claudication (IC) is recommended only for selected patients who have chronic pain or disabling disease. However, improvement in the quality of life (QoL) could justify more widespread use.
  
  
  OBJECTIVE
  To determine the effect of conservative treatment and revascularization on the QoL and physical performance of selected patients with IC.
  
  
  METHODS
  This nonrandomized, parallel group, follow-up study included 83 patients with IC at Fontaine stage II. On the basis of interventional opportunities and the risks and benefits, combined with the preference of the patient, 47 patients were treated conservatively and 41 were revascularized. The patients were examined at inclusion and 3 months later. The evaluations included the QoL measure Short Form 36 (SF-36), the Walking Impairment Questionnaire (WIQ), pain-free and maximal walking distance (treadmill at 3 km/h, no incline), maximal isometric knee-extension strength and endurance, and ankle-brachial blood pressure index (ABI).
  
  
  RESULTS
  At baseline, the SF-36 and WIQ scores and the ABI were significantly lower in the patients selected for revascularization. After revascularization, all dimensions of QoL and functional status increased significantly in the patients who underwent revascularisation compared with the patients treated conservatively. The difference in the change in the physical component summary of SF-36 was 29.4% (P < .001), in the total WIQ 63.6% (P = .0002), and in the pain-free and maximal walking distances 313% (P < .001) and 135% (P < .001), respectively. After adjustment for age, smoking, ABI, body mass index (BMI), and baseline values, the differences remained statistically significant.
  
  
  CONCLUSIONS
  Revascularization above the knee increased QoL, functional status, and walking distance significantly in patients with moderate IC.
authors.affiliation: Surgical Research Unit, Department of Surgery, Regional Hospital Herning, Herning, Denmark. ammomsen@gmail.com
authors.forename: Anne-Mette
authors.initials: AM
authors.lastname: Hedeager Momsen
authors.forename: Martin
authors.initials: M
authors.lastname: Bach Jensen
authors.forename: Charlotte Buchard
authors.initials: CB
authors.lastname: Norager
authors.forename: Mogens
authors.initials: M
authors.lastname: Roerbæk Madsen
authors.forename: Torben
authors.initials: T
authors.lastname: Vestersgaard-Andersen
authors.forename: Jes Sanddal
authors.initials: JS
authors.lastname: Lindholt
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D016009:Chi-Square Distribution; D003718:Denmark; D004185:Disability Evaluation; D005080:Exercise Test; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D010807:Physical Endurance; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures; D016138:Walking