Long Term Results of a Randomised Trial of Stenting of the Superficial Femoral Artery for Intermittent Claudication
(2023) In European journal of vascular and endovascular surgery 65(4). p.513-519- Abstract
Objective: Primary stenting of the superficial femoral artery (SFA) in intermittent claudication (IC) has been shown to increase health related quality of life (HRQoL) after 12 and 24 months. An extended follow up of HRQoL 36 and 60 months after randomisation is presented. Methods: A multicentre randomised controlled trial was conducted at seven vascular clinics in Sweden between 2010 and 2020. One hundred patients randomised to either primary stenting and best medical treatment (BMT; n = 48) or BMT alone (n = 52) were followed for 60 months. HRQoL, assessed by the Short Form 36 Health Survey (SF-36) and EuroQoL 5 dimensions (EQ5D) 36 and 60 months after randomisation, was the primary outcome. Walking Impairment Questionnaire (WIQ)... (More)
Objective: Primary stenting of the superficial femoral artery (SFA) in intermittent claudication (IC) has been shown to increase health related quality of life (HRQoL) after 12 and 24 months. An extended follow up of HRQoL 36 and 60 months after randomisation is presented. Methods: A multicentre randomised controlled trial was conducted at seven vascular clinics in Sweden between 2010 and 2020. One hundred patients randomised to either primary stenting and best medical treatment (BMT; n = 48) or BMT alone (n = 52) were followed for 60 months. HRQoL, assessed by the Short Form 36 Health Survey (SF-36) and EuroQoL 5 dimensions (EQ5D) 36 and 60 months after randomisation, was the primary outcome. Walking Impairment Questionnaire (WIQ) score, re-interventions, progression to chronic limb threatening ischaemia (CLTI), amputation, and death were secondary outcomes. Results: At the 36 month follow up, the stent group (n = 32) had statistically significantly better scores in the SF-36 domain “Role Physical” (p = .023) and the Physical Component Summary (p = .032) compared with the control group (n = 30); however, there was no statistically significant difference in EQ5D scores (p = .52). WIQ was statistically significantly better in the stent group compared with the control group (p = .029) at 36 months. At the 60 month follow up, no statistically significant difference in HRQoL was seen between patients in the stent (n = 31) and control groups (n = 32). Crossover from the control group to the stent group was 25% at 60 months. There were no differences in progression to CLTI, amputation (2.1% vs. 1.9%), or mortality (14.6% vs. 15.4%) between groups. Conclusion: In patients with IC caused by isolated SFA lesions, primary stenting conferred benefits to HRQoL until 36 months from treatment vs. BMT alone, but these benefits were no longer detectable at 60 months, where a high crossover rate affected the power of the final analysis.
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- author
- Gunnarsson, Thordur LU ; Bergman, Stefan ; Pärsson, Håkan ; Gottsäter, Anders LU and Lindgren, Hans LU
- organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Health related quality of life, Intermittent claudication, Long term follow up, Stent treatment, Superficial femoral artery
- in
- European journal of vascular and endovascular surgery
- volume
- 65
- issue
- 4
- pages
- 513 - 519
- publisher
- Elsevier
- external identifiers
-
- pmid:36642399
- scopus:85147576651
- ISSN
- 1078-5884
- DOI
- 10.1016/j.ejvs.2023.01.004
- language
- English
- LU publication?
- yes
- id
- 01668b61-2842-4489-9ba0-29595bb6aa57
- date added to LUP
- 2023-02-21 11:58:27
- date last changed
- 2024-07-12 21:26:19
@article{01668b61-2842-4489-9ba0-29595bb6aa57,
abstract = {{<p>Objective: Primary stenting of the superficial femoral artery (SFA) in intermittent claudication (IC) has been shown to increase health related quality of life (HRQoL) after 12 and 24 months. An extended follow up of HRQoL 36 and 60 months after randomisation is presented. Methods: A multicentre randomised controlled trial was conducted at seven vascular clinics in Sweden between 2010 and 2020. One hundred patients randomised to either primary stenting and best medical treatment (BMT; n = 48) or BMT alone (n = 52) were followed for 60 months. HRQoL, assessed by the Short Form 36 Health Survey (SF-36) and EuroQoL 5 dimensions (EQ5D) 36 and 60 months after randomisation, was the primary outcome. Walking Impairment Questionnaire (WIQ) score, re-interventions, progression to chronic limb threatening ischaemia (CLTI), amputation, and death were secondary outcomes. Results: At the 36 month follow up, the stent group (n = 32) had statistically significantly better scores in the SF-36 domain “Role Physical” (p = .023) and the Physical Component Summary (p = .032) compared with the control group (n = 30); however, there was no statistically significant difference in EQ5D scores (p = .52). WIQ was statistically significantly better in the stent group compared with the control group (p = .029) at 36 months. At the 60 month follow up, no statistically significant difference in HRQoL was seen between patients in the stent (n = 31) and control groups (n = 32). Crossover from the control group to the stent group was 25% at 60 months. There were no differences in progression to CLTI, amputation (2.1% vs. 1.9%), or mortality (14.6% vs. 15.4%) between groups. Conclusion: In patients with IC caused by isolated SFA lesions, primary stenting conferred benefits to HRQoL until 36 months from treatment vs. BMT alone, but these benefits were no longer detectable at 60 months, where a high crossover rate affected the power of the final analysis.</p>}},
author = {{Gunnarsson, Thordur and Bergman, Stefan and Pärsson, Håkan and Gottsäter, Anders and Lindgren, Hans}},
issn = {{1078-5884}},
keywords = {{Health related quality of life; Intermittent claudication; Long term follow up; Stent treatment; Superficial femoral artery}},
language = {{eng}},
number = {{4}},
pages = {{513--519}},
publisher = {{Elsevier}},
series = {{European journal of vascular and endovascular surgery}},
title = {{Long Term Results of a Randomised Trial of Stenting of the Superficial Femoral Artery for Intermittent Claudication}},
url = {{http://dx.doi.org/10.1016/j.ejvs.2023.01.004}},
doi = {{10.1016/j.ejvs.2023.01.004}},
volume = {{65}},
year = {{2023}},
}