Minar Erich
Medical University Clinic Vienna, Austria.
Vasa. 2015 Mar;44(2):85-91. doi: 10.1024/0301-1526/a000413.
The generally accepted first-line treatment in patients with intermittent claudication is risk factor modification, medical treatment and exercise training. In an era of reduced resources, the benefit of any further invasive intervention must be weighted against best conservative therapy for patients with claudication. According to some recent trials an integrative therapeutic concept combining best conservative treatment - including (supervised) exercise therapy - with endovascular therapy gives the best midterm results concerning walking distance and health-related quality of life. The improved mid- and long-term patency rate with use of modern technology further supports this concept. The conservative and interventional treatment strategy are more complimentary than competitive. The current main challenge is to overcome the economic barriers concerning the availability of exercise programmes.
间歇性跛行患者普遍接受的一线治疗方法是改善危险因素、药物治疗和运动训练。在资源减少的时代，必须权衡任何进一步侵入性干预措施的益处与针对跛行患者的最佳保守治疗。根据最近的一些试验，将最佳保守治疗（包括（有监督的）运动疗法）与血管内治疗相结合的综合治疗理念，在步行距离和健康相关生活质量方面能取得最佳中期效果。使用现代技术提高的中长期通畅率进一步支持了这一理念。保守治疗和介入治疗策略更多的是互补而非竞争。当前的主要挑战是克服与运动计划可用性相关的经济障碍。
