Do patients with intermittent claudication need surgical treatment?

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Peripheral Artery Disease

Background:

• Intermittent claudication (IC) significantly impacts patient quality of life.
• The therapeutic role of surgical intervention in IC remains a subject of investigation.
• Understanding symptom improvement and prognosis based on intervention is crucial.

Purpose of the Study:

• To evaluate the therapeutic significance of surgical intervention for intermittent claudication (IC).
• To analyze symptom changes and prognosis in operated versus non-operated IC patients.
• To determine the influence of claudication distance and arterial lesion location on surgical outcomes.

Main Methods:

• Retrospective analysis of 315 intermittent claudication patients (142 non-operated, 173 operated) over 8 years.
• Symptom changes assessed based on claudication distance and affected artery location.
• Goodman and Kruskal's gamma used to correlate surgery with symptom improvement.

Main Results:

• Surgery inversely correlated with symptom improvement across all claudication distances (gamma from -0.378 to -0.828).
• Surgical intervention showed positive correlation with symptom improvement in aorto-iliac and superficial femoral artery disease.
• No significant difference in prognosis between operated and non-operated groups (p=0.35).

Conclusions:

• Surgical intervention is therapeutically significant for IC patients with aorto-iliac or multi-arterial involvement.
• Surgery provides limited benefit for IC patients with isolated superficial femoral or infrapopliteal artery disease.
• Prognosis is similar between surgical and non-surgical management for IC.