Quality of life and exercise performance after aortoiliac stent placement for claudication.

Abstract

PURPOSE:

To determine the effect of aortoiliac stent placement on walking ability and health-related quality of life (QOL) for elderly individuals with moderate to severe intermittent claudication.

MATERIALS AND METHODS:

A prospective single-center study was performed in 35 consecutive patients (46 symptomatic limbs) with intermittent claudication and aortoiliac insufficiency (mean age+/-SD, 61.1 years+/-9.5). Baseline and follow-up data to 12 months included clinical status, ankle-brachial index (ABI), exercise performance according to a standardized treadmill exercise protocol, and self-reported health-related QOL according to the Walking Impairment Questionnaire (WIQ) and the Short Form 36 (SF-36).

RESULTS:

Comparing baseline with 12-month data, mean ABI significantly improved from 0.64+/-0.15 to 0.89+/-0.19 (P<.01). Similarly, mean initial claudication duration improved from 1.7 minutes+/-1.0 to 4.7 minutes+/-3.3 and maximum walking duration on the treadmill test improved from a mean of 3.3 minutes+/-1.8 to 8.7 minutes+/-4.4. All WIQ subscales showed significant improvement, and the SF-36 physical component scale as well as subscales of physical functioning, bodily pain, role physical, and vitality showed significant improvement. There was no 30-day mortality. Complications in the perioperative period that required treatment were observed in three patients (9%), but surgery was not required for any complications. Importantly, urgent or emergent surgery was not required for any complication and no permanent disability related to complications occurred.

CONCLUSIONS:

A high technical success rate (97%) and low complication rate were observed. Exercise performance and health-related QOL results improved significantly after stent placement. Revascularization with stent placement should be strongly considered in addition to conservative management for moderate to severe claudication with aortoiliac obstruction. A randomized clinical trial would be needed to gauge the relative effectiveness of stent implantation and conservative therapy.

• Authors: Timothy P Murphy, Gregory M Soares, H Myra Kim, Sun H Ahn, Richard A Haas
• Journal: Journal of vascular and interventional radiology : JVIR (J Vasc Interv Radiol) Vol. 16 Issue 7 Pg. 947-53; quiz 954 (Jul 2005) ISSN: 1051-0443 [Print] United States
• PMID: 16002502 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Aged
• Aorta, Abdominal
• Exercise Tolerance
• Female
• Humans
• Iliac Artery
• Intermittent Claudication (physiopathology, therapy)
• Male
• Middle Aged
• Prospective Studies
• Quality of Life
• Stents
• Surveys and Questionnaires
• Treatment Outcome
• Walking