Document Detail


Comparison of the results of percutaneous transluminal angioplasty and stenting with medical treatment for claudicants who have superficial femoral artery occlusive disease.
MedLine Citation:
PMID:  16956476     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The outcomes of medical management of peripheral vascular disease localized to the superficial femoral artery (SFA) were compared with those obtained by percutaneous transluminal angioplasty (PTA) with or without stenting in a review of selected studies. The natural history of localized SFA disease is favorable, with major amputation rates less than 10% and revascularization in only 18% of patients over a 10-year interval. Conservative treatment of claudicants shows increases (150%) in walking distance if the ankle brachial index (ABI) is over 0.6 and patients stop smoking. Analysis of 10 trials (882 patients) of PTA with or without stenting found that the overall primary patency rates at 12 months were 71.1% for PTA plus stenting and 58.3% for PTA alone. Technical success with PTA with or without stenting is over 90%, and early results at 6 months are superior to those with exercise. In three randomized controlled trials, however, the difference between PTA and medical treatment at 2 years, whether measured by walking distance or ABI, was not significant, nor was the quality of life. For long-term improvement in walking distance (> 1 year) in the claudicant, intervention is not superior to medical treatment and a monitored exercise program. Consideration should be given to including a nonintervention control group and 2-year outcomes in the evaluation of new SFA stents.
Authors:
Samuel Wilson; Dmitri Gelfand; Juan Jimenez; Ian Gordon
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Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  Vascular     Volume:  14     ISSN:  1708-5381     ISO Abbreviation:  Vascular     Publication Date:    2006 Mar-Apr
Date Detail:
Created Date:  2006-09-07     Completed Date:  2007-05-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101196722     Medline TA:  Vascular     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  81-7     Citation Subset:  IM    
Affiliation:
Long Beach Veterans Affairs Madical Center, Department of Surgery, Orange, CA, USA. Wilsonse@uci.edu
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Balloon*
Arterial Occlusive Diseases / drug therapy,  therapy*
Exercise Therapy
Femoral Artery / physiology*
Humans
Intermittent Claudication / drug therapy,  therapy*
Stents*
Thrombolytic Therapy
Treatment Outcome
Vascular Patency

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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