Endovascular Treatment of External Iliac Artery Stenoses for Claudication with Systematic Stenting

Maurel, Blandine; Lancelevee, Julien; Jacobi, David; Bleuet, François; Martinez, Robert; Lermusiaux, Patrick

doi:10.1016/j.avsg.2008.05.019

Cited by 25 publications

(18 citation statements)

References 20 publications

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“…Over the last decade, the number of such procedures has increased 3-fold (12). Although outcomes of aortoiliac artery stent placement for claudication in uncontrolled studies are excellent (13,14), it is also known that patients with PAD appreciate the benefits of low-risk interventions when available (15). CLEVER (Claudication: Exercise Versus Endoluminal Revascularization) is a comparative effectiveness study that compared outcomes for aortoiliac stenting (ST) or supervised exercise (SE) with optimal medical therapy (OMT) at 6 and 18 months.…”

Section: Introductionmentioning

confidence: 99%

Supervised Exercise, Stent Revascularization, or Medical Therapy for Claudication Due to Aortoiliac Peripheral Artery Disease

Murphy

Cutlip

Regensteiner³

et al. 2015

Journal of the American College of Cardiology

245

128

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Background Treatment for claudication due to aortoiliac peripheral artery disease (PAD) often relies on stent revascularization. However, supervised exercise is known to provide comparable short-term (6-month) improvements in functional status and quality of life. Longer-term outcomes are not known. Objectives The goal of this study was to report the longer-term (18-month) efficacy of supervised exercise compared with stenting and optimal medical care. Methods Of 111 patients with aortoiliac PAD randomly assigned to receive optimal medical care (OMC), OMC plus supervised exercise (SE), or OMC plus stent revascularization (ST), 79 completed the 18-month clinical and treadmill follow-up assessment. SE consisted of 6 months of supervised exercise and an additional year of telephone-based exercise counseling. Primary clinical outcomes included objective treadmill-based walking performance and subjective quality of life. Results Peak walking time improved from baseline to 18 months for both SE (5.0 ± 5.4 min) and ST (3.2 ± 4.7 min; p < 0.001) compared with OMC (0.2 ± 2.1 min, p = 0.04). The difference between SE and ST was not significant (p = 0.16). Improvement in claudication onset time (COT) was greater for SE compared with OMC, but not for ST compared with OMC. Many disease-specific quality-of-life scales demonstrated durable improvements that were greater for ST compared with SE or OMC. Conclusions Both SE and ST had better 18-month outcomes than OMC. SE and ST provided comparable durable improvement in functional status and in quality of life up to 18 months. The durability of claudication exercise interventions merits its consideration as a primary PAD claudication treatment. Claudication: Exercise Versus Endoluminal Revascularization [CLEVER]: NCT00132743

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Section: Introductionmentioning

confidence: 99%

Supervised Exercise, Stent Revascularization, or Medical Therapy for Claudication Due to Aortoiliac Peripheral Artery Disease

Murphy

Cutlip

Regensteiner³

et al. 2015

Journal of the American College of Cardiology

245

128

View full text Add to dashboard Cite

show abstract

“…8,17 Those investigations demonstrated long segment occlusion, diabetes mellitus, female gender, stent diameter Ͻ8 mm, current smoking, and critical limb ischemia as risk factors. In the present study, Cox multivariate analysis indicated lesion length as an independent risk factor for restenosis.…”

Section: Discussionmentioning

confidence: 98%

Long-term outcomes for systematic primary stent placement in complex iliac artery occlusive disease classified according to Trans-Atlantic Inter-Society Consensus (TASC)-II

Ichihashi

Higashiura

Itoh

et al. 2011

Journal of Vascular Surgery

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“…1,2 However, recent clinical studies with new endovascular devices and stents have demonstrated improved outcomes of endovascular treatment in more extensive aortoiliac occlusive disease. 4,13,14 Several studies reported the efficacy of IA with stent implantation for the treatment of chronic total occlusion of iliac arteries. [15][16][17][18][19] The technical success rate ranged from 92% to 99%, and the major complication rate varied between 7% and 19%.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of stent-supported subintimal angioplasty in the treatment of long iliac artery occlusions

Shin

Kim

et al. 2011

Journal of Vascular Surgery

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Endovascular Treatment of External Iliac Artery Stenoses for Claudication with Systematic Stenting

Cited by 25 publications

References 20 publications

Supervised Exercise, Stent Revascularization, or Medical Therapy for Claudication Due to Aortoiliac Peripheral Artery Disease

Supervised Exercise, Stent Revascularization, or Medical Therapy for Claudication Due to Aortoiliac Peripheral Artery Disease

Long-term outcomes for systematic primary stent placement in complex iliac artery occlusive disease classified according to Trans-Atlantic Inter-Society Consensus (TASC)-II

Efficacy of stent-supported subintimal angioplasty in the treatment of long iliac artery occlusions

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