Abstract
Noninvasive tests may be used to aid in deciding the treatment of patients with vascular disease by providing hemodynamic information. The authors stud ied whether the information on the severity of the disease and the location of the diseased segment had any predictive value in regard to the results of nonoper ative treatment of patients with intermittent claudication.
Two hundred and one patients suffering from intermittent claudication and not recommended for operative treatment entered the study. They all had nonin vasive tests done, including segmental blood pressure measurements and femo ral velocity waveform analyses. After two years the mortality, surgical intervention rate, patient's subjective assessment, and changes in ankle-brachial index were recorded and analyzed.
Twenty-nine patients had died and 12 patients had been operated on during the follow-up. The severity of the disease influenced the mortality; the lower the ankle-brachial index, the higher the mortality. The patients' subjective feel ings of change in symptoms were not affected by the severity of the disease at the start.
The location of the disease, whether aortoiliac, femoropopliteal, or femorotibial, did not affect the progression of the disease, but it strongly influenced the patients' subjective assessment of the results of conservative treat ment. Patients with proximal disease were less satisfied with conservative treat ment and more often needed surgical intervention.
At the two-year follow-up, 53% of the patients felt better, 35% felt unchanged, and 12% felt worse. Patients' assessments of disease progression are good.
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