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Exercise, Endovascular Therapy Help Claudication

Revascularization held immediate advantage, but clinical success was similar in groups at six months

FRIDAY, Feb. 6 (HealthDay News) -- Treating intermittent claudication with revascularization may offer immediate advantages over a supervised exercise intervention, but the two offer similar benefits after six months, according to research published in the February issue of Radiology.

Sandra Spronk, Ph.D., of Ikazia Hospital in Rotterdam, the Netherlands, and colleagues analyzed data from 150 patients with Rutherford category 1, 2, or 3 intermittent claudication of at least three months. Patients were randomized to receive endovascular revascularization or a 24-week supervised treadmill exercise program, held for 30 minutes twice weekly. Clinical success -- defined as improvement in at least one category in the Rutherford scale above pretreatment values -- was measured at one week and at six and 12 months.

At one week following revascularization or the initial exercise sessions, those in the revascularization group were more likely to have clinical success than the exercise group (88 percent versus 16 percent), the investigators found. However, no significant difference in clinical success was seen at six or 12 months. Both groups showed improvements in functional capacity and quality of life at six and 12 months, with no significant differences between the two, the researchers report.

"Exercise training is recommended as an initial treatment for intermittent claudication by the TransAtlantic Inter-Society Consensus (TASC). Endovascular revascularization, however, is becoming more common, presumably because its immediate benefit may prevent unnecessary disability," the authors write. "While patients in the revascularization group scored better in clinical success shortly after the start of treatment, the benefit compared with exercise was lost over time."

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