NEW YORK (Reuters Health) – As treatments for intermittent claudication, endovascular revascularization and supervised exercise training provide similar improvements in symptoms, function, and quality of life, although these benefits appear sooner with revascularization, new research shows.

The results, reported in the February issue of Radiology, stem from a study of 151 consecutive patients who were randomized to undergo either treatment and were evaluated 6 and 12 months later. The exercise training was hospital-based and involved 30 minutes of treadmill walking twice weekly for 24 weeks.

Clinical success was defined as an improvement of one or more categories in the Rutherford scale, a gauge of claudication severity.

Immediately following treatment, clinical success rates were higher with revascularization than with exercise, but by 6 and 12 months, success rates were comparable in each group, Dr. Sandra Spronk, from Erasmus Medical Center, Rotterdam, the Netherlands, and co-researchers note.

Specifically, success rates at 1 week were 88% in the revascularization group and 16% in the exercise group; corresponding rates at 6 months were 75% and 77%, and at 12 months they were 68% and 65%.

At 6 months, revascularization-treated patients were less likely to have ipsilateral symptoms than were exercise-treated patients (p < 0.001). By 12 months, however, this difference had disappeared.

At both 6 and 12 months, functional capacity and quality of life scores had improved to a similar extent in each group, the researchers report.

While the findings indicate that revascularization and exercise are each effective treatments for intermittent claudication, the best approach might be a combination of both.

“Revascularization plus exercise would presumably combine effective short-term relief of claudication symptoms with the added long-term benefits of exercise training,” the authors write. “To the best of our knowledge, (this combined approach) has never been studied in a large randomized controlled trial.”

Reference:
Radiology 2009;250:586-595.