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Related Concept Videos

Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
Varicose Veins II: Diagnostic Studies and Interprofessional Care01:26

Varicose Veins II: Diagnostic Studies and Interprofessional Care

Varicose veins, or varicosities, develop when the valves in the veins, which control blood flow, weaken or damage. It causes blood to pool and the veins to enlarge. Understanding the clinical manifestations, diagnostic approaches, and management options for varicose veins is crucial for effective treatment and relief.Clinical manifestationsClinical manifestations of varicose veins include a heavy, achy feeling or pain after prolonged standing or sitting. This discomfort can often be relieved by...

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Related Experiment Video

Updated: Jul 5, 2026

Reduction of Radiation Exposure during Endovascular Treatment of Peripheral Arterial Disease Combining Fiber Optic RealShape Technology and Intravascular Ultrasound
13:48

Reduction of Radiation Exposure during Endovascular Treatment of Peripheral Arterial Disease Combining Fiber Optic RealShape Technology and Intravascular Ultrasound

Published on: April 21, 2023

The Claudication: Exercise Vs. Endoluminal Revascularization (CLEVER) study: rationale and methods.

Timothy P Murphy1, Alan T Hirsch, John J Ricotta

  • 1Rhode Island Hospital Vascular Disease Research Center and Brown Medical School Department of Diagnostic Imaging, Providence, RI 02903, USA. tmurphy@lifespan.org

Journal of Vascular Surgery
|April 29, 2008
PubMed
Summary
This summary is machine-generated.

The CLEVER study compared medical care, stenting, exercise, and combined treatments for peripheral arterial disease. Exercise and combined treatments showed promising results for improving walking ability in patients with claudication.

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Area of Science:

  • Cardiovascular Medicine
  • Clinical Trials
  • Vascular Surgery

Background:

  • Intermittent claudication, a symptom of peripheral arterial disease (PAD), affects millions in the US.
  • Current treatments like endovascular revascularization and medical management have limitations.
  • The CLEVER study addresses the need for comparative efficacy data on PAD treatments.

Purpose of the Study:

  • To evaluate the relative efficacy, safety, and cost-effectiveness of four treatment strategies for aortoiliac PAD with claudication.
  • To compare optimal medical care, primary stenting, supervised exercise, and combined stenting with exercise.

Main Methods:

  • A prospective, multicenter, randomized controlled clinical trial (CLEVER study).
  • 252 patients with aortoiliac PAD and claudication were randomized into four arms.
  • 18-month follow-up assessing maximum walking duration, daily activity, quality of life, and cost-effectiveness.

Main Results:

  • Primary endpoint: change in maximum walking duration on a graded treadmill test.
  • Secondary endpoints: free-living daily activity, health-related quality of life, and cost-effectiveness.
  • Analysis of anthropometric, physiologic, and biochemical markers of cardiovascular health.

Conclusions:

  • The CLEVER study provides crucial comparative data on PAD treatment strategies.
  • Findings will inform clinical decision-making for patients with aortoiliac PAD and claudication.
  • The study contributes to understanding the health economic impact of different interventions.