Study: Revascularization beats medical management for intermittent claudication in PAD

Revascularization through endovascular or surgical interventions may be superior to medical management for peripheral artery disease patients with intermittent claudication, according to a new study from the University of Washington, Seattle.

Data from the study was published online in JAMA Surgery.

The study reported that patients with intermittent claudication, which presents as pain in the calf or foot while walking, who underwent revascularization procedures showed improved walk function, reported better health-related quality of life and fewer symptoms of claudification at 12 months than those who were treated only with medical management.

“This comparative effectiveness research study of interventions for IC demonstrated significantly higher function, better HRQoL, and fewer symptoms for those in the revascularization cohort compared with the medical cohort. These results suggest that revascularization interventions for patients with moderate to severe IC represent a reasonable alternative to medical management, providing important information to inform treatment strategies in the community,” study authors wrote.

The 323-patient study compared the effectiveness of medical management, through walking programs, smoking cessation counseling and medications, with surgical revascularization in treating interimittent claudication, with a focus on outcomes of “greatest importance to patients.”

At 1-year, patients in the medical management cohort had improved across 3 measurements: speed, scores on the Vascular Quality of Life questionnaire and scores on the European Quality of Life-5 Dimension questionnaire.

For patients in the revascularization cohort, improvements were noted across the same 3 measurements, as well as 4 others: distance traveled, stair climbing, pain rating and scores on the Claudication Symptom Instrument, which assesses claudication symptoms in the leg or foot.

Patients in the revascularization cohort reported 39% improvements in distance traveled, 16% improvements in speed, 10% improvements at stair climbing and a massive 117% improvement in pain rating. Scores across questionnaire measurements were up 41% for the Vascular Quality of Life questionnaire, 18% for the European Quality of Life-5 Dimension questionnaire and 14% improved on the Claudication Symptom Instrument.

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