title: Additional functional outcomes after endovascular treatment for intermittent claudication.
abstract: Background Endovascular treatment (EVT) for intermittent claudication (IC) is performed in selected patients where conservative treatment and training fail. Treatment outcomes reported in vascular registries (survival, limb-survival, and re-intervention rate) are inadequate for low-risk patients with IC. Additional measurements of blood flow reduction and functional impairment clarify the indication for treatment and facilitate outcome evaluation. Purpose To analyze the additional outcome information on peripheral arterial pressures and walking capacity obtained from a local registry of EVT. Material and Methods Patients with IC treated with endovascular technique (angioplasty or stent) were prospectively entered into a local registry in addition to the national registry (NORKAR), with information on arterial pressures (ankle brachial index [ABI]) and treadmill performance (maximum walking distance [MWD]). Results A total of 242 consecutive patients (41% women; median age, 70 years) receiving the first treatment between July 2010 and December 2012 were included, 61% with aorto-iliac lesions. After 3 months, mean ABI increased from 0.62 (0.59-0.64) to 0.85 (0.83-0.87). The median MWD increased from 160 m to 410 m. Sixty-two percent reached the test maximum of 10 min. The improvement in ABI and MWD persisted after 1 year. When preoperative ABI was moderately reduced (0.5-0.9), ABI was normal in 61% after 3 months and in 55% after 1 year. When preoperative ABI was low (<0.5), ABI was normal in 43% both after 3 months and 1 year. Conclusion ABI and walking capacity were important outcome variables and improved after EVT. ABI improvement was better for patients with moderately reduced preoperative ABI than with low ABI.
authors.affiliation: 1 Department of Radiology, Ostfold Hospital Trust, Sarpsborg, Norway.|2 Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Anne Sofie F
authors.initials: ASF
authors.lastname: Larsen
authors.affiliation: 2 Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.|3 Department of Internal Medicine, Ostfold Hospital Trust, Sarpsborg, Norway.|4 Norwegian University of Life Sciences, Aas, Norway.
authors.forename: Morten B
authors.initials: MB
authors.lastname: Jacobsen
authors.affiliation: 2 Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.|5 Department of Vascular and Thoracic Surgery, Akershus University Hospital, Lørenskog, Norway.
authors.forename: Jarlis
authors.initials: J
authors.lastname: Wesche
authors.affiliation: 2 Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.|6 Department of Radiology, Oslo University Hospital, Oslo, Norway.
authors.forename: Nils Einar
authors.initials: NE
authors.lastname: Kløw
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D057510:Endovascular Procedures; D005080:Exercise Test; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D011446:Prospective Studies; D020127:Recovery of Function; D012042:Registries; D015607:Stents; D016896:Treatment Outcome
keywords: Endovascular procedures; ankle brachial index (ABI); intermittent claudication; peripheral arterial disease; treadmill test