Functional outcome after surgical treatment for intermittent claudication

Area of Science:

• Vascular Surgery
• Patient-Reported Outcomes
• Intermittent Claudication Treatment

Background:

• Lower extremity bypass graft patency data is available, but patient satisfaction post-surgery for claudication is less studied.
• Surgical reconstruction aims to improve function and quality of life for patients with intermittent claudication.

Purpose of the Study:

• To review surgical treatment outcomes for intermittent claudication from the patient's perspective.
• To identify factors influencing patient satisfaction and refine surgical decision-making for claudication.

Main Methods:

• 105 patients undergoing bypass for intermittent claudication (1987-1994) were analyzed.
• Follow-up included patient interviews assessing satisfaction and function using a five-point questionnaire.
• Actuarial methods and Cox regression identified predictors of graft patency, survival, and patient satisfaction.

Main Results:

• 82% of patients reported satisfactory late results.
• Younger age (≤70 years) and normalized ankle-brachial index (>0.85) independently predicted patient satisfaction.
• Diabetes was a negative predictor of survival; cancer caused 60% of late deaths.

Conclusions:

• Lower extremity bypass grafting for intermittent claudication is most effective in younger, nondiabetic patients.
• Achieving near-normal postoperative ankle-brachial index is crucial for optimal patient outcomes.
• Patient selection considering cardiac prognosis and specific patient factors enhances surgical success.