Document Detail

Conservative management of intermittent claudication.
MedLine Citation:
PMID:  2141775     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To review the evidence for efficacy of three contemporary treatments for intermittent claudication: pentoxifylline, exercise programs, and smoking cessation. DATA IDENTIFICATION: English-language literature search using MEDLINE, Index Medicus, and bibliographic reviews of major texts and all pertinent articles. STUDY SELECTION: For pentoxifylline, randomized, double-blind controlled trials were selected. For exercise, all controlled trials were selected, because few randomized trials have been done. For smoking cessation, 26 pertinent studies were selected after an exhaustive search. DATA EXTRACTION: Study quality was evaluated; therapeutic efficacy was estimated for pentoxifylline and exercise using meta-analytic techniques. For smoking cessation, all outcomes were determined and described. RESULTS: For pentoxifylline, insufficiently reported data led to marked disparity in effect sizes, preventing a meaningful pooled estimate of effectiveness. The results for exercise therapy suggested that dynamic exercise is beneficial (pooled effect size for pain-free walking distance = 1.03; 95% CI, 0.6 to 1.5; P less than 0.0001). Finally, smoking cessation was associated with a reduced frequency of complications due to progressive disease and improved postoperative graft patency rates. CONCLUSIONS: The limited amount and quality of reported data precluded an overall, reliable estimate of pentoxifylline's efficacy. Structured exercise programs increased pain-free walking distance, and smoking cessation improved postoperative graft patency rates and reduced the complications of peripheral arterial disease.
K Radack; R J Wyderski
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Publication Detail:
Type:  Clinical Trial; Journal Article; Meta-Analysis; Randomized Controlled Trial    
Journal Detail:
Title:  Annals of internal medicine     Volume:  113     ISSN:  0003-4819     ISO Abbreviation:  Ann. Intern. Med.     Publication Date:  1990 Jul 
Date Detail:
Created Date:  1990-08-02     Completed Date:  1990-08-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0372351     Medline TA:  Ann Intern Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  135-46     Citation Subset:  AIM; IM    
University of Cincinnati College of Medicine, Ohio.
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MeSH Terms
Double-Blind Method
Exercise Therapy*
Intermittent Claudication / therapy*
Meta-Analysis as Topic
Pentoxifylline / therapeutic use*
Randomized Controlled Trials as Topic
Smoking / prevention & control*
Theobromine / analogs & derivatives*
Reg. No./Substance:
6493-05-6/Pentoxifylline; 83-67-0/Theobromine

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

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