The adjuvant benefit of angioplasty in patients with mild to moderate intermittent claudication (MIMIC)  managed by supervised exercise, smoking cessation advice and best medical therapy: results from two randomised trials for stenotic femoropopliteal and aortoiliac arterial disease the MIMIC trial participants (See Appendix 1)

R. M. Greenhalgh; J. J. F. Belch; L. C. Brown; P. A. Gaines; L. Gao; J. A. Reise; S. G. Thompson; MIMIC Trial Participants

doi:10.1016/j.ejvs.2008.10.007

The adjuvant benefit of angioplasty in patients with mild to moderate intermittent claudication (MIMIC) managed by supervised exercise, smoking cessation advice and best medical therapy: results from two randomised trials for stenotic femoropopliteal and aortoiliac arterial disease the MIMIC trial participants (See Appendix 1)

R. M. Greenhalgh, J. J. F. Belch, L. C. Brown, P. A. Gaines, L. Gao, J. A. Reise, S. G. Thompson, MIMIC Trial Participants

Research output: Contribution to journal › Article › peer-review

166 Citations (Scopus)

Abstract

Background: Uncertainty exists on whether there is adjuvant benefit of percutaneous transluminal angioplasty (PTA) over supervised exercise and best medical therapy in the treatment of intermittent claudication.

Methods: Patients with symptoms of stable mild to moderate intermittent claudication (MIMIC) were randomised in two multi-centre trials, for femoropopliteal and aortoiliac arterial disease, to receive either PTA or no PTA against a background of supervised exercise and best medical therapy and followed up for 24 months. Initial claudication distance (ICD) and absolute walking distance (AWD) on treadmill were compared between randomised groups adjusting for the corresponding measure at baseline. Secondary outcomes included ankle-brachial pressure index (ABPI) and quality of life.

Findings: A total of 93 patients were randomised into the femoropopliteal trial (48 into PTA) and 34 into the aortoiliac trial (19 to PTA). The mean (standard deviation, SD) age was 66(9) years for the femoropopliteal trial (63% male) and 63(9) for the aortoiliac trial (65% mate). At 24 months, there were significant improvements in both AWD and ICD in the PTA groups for both trials. The adjusted AWD was 38% greater in the PTA group for the femoropopliteal trial (95%; CI 1-90) (p = 0.04) and 78% greater in the PTA group for the aortoiliac trial (95%; CI 0-216) (p = 0.05). Further benefits were demonstrated for ABPI but not for quality of life.

Interpretation: PTA confers adjuvant benefit over supervised exercise and best medical therapy in terms of walking distances and ABPI 24 months after PTA in patients with stable mild to moderate intermittent claudication. (C) 2008 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Original language	English
Pages (from-to)	680-688
Number of pages	9
Journal	European Journal of Vascular and Endovascular Surgery
Volume	36
Issue number	6
DOIs	https://doi.org/10.1016/j.ejvs.2008.10.007
Publication status	Published - 2008

Keywords

Percutaenous transluminal angioplasty
Intermittent claudication
Femoropopliteal
Aortoiliac
Occlusive or stenotic arterial disease
Walking distance
Treadmill test
ABPI
PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY
SUPERFICIAL FEMORAL-ARTERY
NITINOL STENT IMPLANTATION
WALKING DISTANCE
LESIONS

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Greenhalgh, R. M., Belch, J. J. F., Brown, L. C., Gaines, P. A., Gao, L., Reise, J. A., Thompson, S. G., & MIMIC Trial Participants (2008). The adjuvant benefit of angioplasty in patients with mild to moderate intermittent claudication (MIMIC) managed by supervised exercise, smoking cessation advice and best medical therapy: results from two randomised trials for stenotic femoropopliteal and aortoiliac arterial disease the MIMIC trial participants (See Appendix 1). European Journal of Vascular and Endovascular Surgery, 36(6), 680-688. https://doi.org/10.1016/j.ejvs.2008.10.007

Greenhalgh, R. M. ; Belch, J. J. F. ; Brown, L. C. et al. / The adjuvant benefit of angioplasty in patients with mild to moderate intermittent claudication (MIMIC) managed by supervised exercise, smoking cessation advice and best medical therapy : results from two randomised trials for stenotic femoropopliteal and aortoiliac arterial disease the MIMIC trial participants (See Appendix 1). In: European Journal of Vascular and Endovascular Surgery. 2008 ; Vol. 36, No. 6. pp. 680-688.

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title = "The adjuvant benefit of angioplasty in patients with mild to moderate intermittent claudication (MIMIC) managed by supervised exercise, smoking cessation advice and best medical therapy: results from two randomised trials for stenotic femoropopliteal and aortoiliac arterial disease the MIMIC trial participants (See Appendix 1)",

abstract = "Background: Uncertainty exists on whether there is adjuvant benefit of percutaneous transluminal angioplasty (PTA) over supervised exercise and best medical therapy in the treatment of intermittent claudication.Methods: Patients with symptoms of stable mild to moderate intermittent claudication (MIMIC) were randomised in two multi-centre trials, for femoropopliteal and aortoiliac arterial disease, to receive either PTA or no PTA against a background of supervised exercise and best medical therapy and followed up for 24 months. Initial claudication distance (ICD) and absolute walking distance (AWD) on treadmill were compared between randomised groups adjusting for the corresponding measure at baseline. Secondary outcomes included ankle-brachial pressure index (ABPI) and quality of life.Findings: A total of 93 patients were randomised into the femoropopliteal trial (48 into PTA) and 34 into the aortoiliac trial (19 to PTA). The mean (standard deviation, SD) age was 66(9) years for the femoropopliteal trial (63% male) and 63(9) for the aortoiliac trial (65% mate). At 24 months, there were significant improvements in both AWD and ICD in the PTA groups for both trials. The adjusted AWD was 38% greater in the PTA group for the femoropopliteal trial (95%; CI 1-90) (p = 0.04) and 78% greater in the PTA group for the aortoiliac trial (95%; CI 0-216) (p = 0.05). Further benefits were demonstrated for ABPI but not for quality of life.Interpretation: PTA confers adjuvant benefit over supervised exercise and best medical therapy in terms of walking distances and ABPI 24 months after PTA in patients with stable mild to moderate intermittent claudication. (C) 2008 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.",

keywords = "Percutaenous transluminal angioplasty, Intermittent claudication, Femoropopliteal, Aortoiliac, Occlusive or stenotic arterial disease, Walking distance, Treadmill test, ABPI, PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY, SUPERFICIAL FEMORAL-ARTERY, NITINOL STENT IMPLANTATION, WALKING DISTANCE, LESIONS",

author = "Greenhalgh, {R. M.} and Belch, {J. J. F.} and Brown, {L. C.} and Gaines, {P. A.} and L. Gao and Reise, {J. A.} and Thompson, {S. G.} and {MIMIC Trial Participants}",

year = "2008",

doi = "10.1016/j.ejvs.2008.10.007",

language = "English",

volume = "36",

pages = "680--688",

journal = "European Journal of Vascular and Endovascular Surgery",

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Greenhalgh, RM, Belch, JJF, Brown, LC, Gaines, PA, Gao, L, Reise, JA, Thompson, SG & MIMIC Trial Participants 2008, 'The adjuvant benefit of angioplasty in patients with mild to moderate intermittent claudication (MIMIC) managed by supervised exercise, smoking cessation advice and best medical therapy: results from two randomised trials for stenotic femoropopliteal and aortoiliac arterial disease the MIMIC trial participants (See Appendix 1)', European Journal of Vascular and Endovascular Surgery, vol. 36, no. 6, pp. 680-688. https://doi.org/10.1016/j.ejvs.2008.10.007

The adjuvant benefit of angioplasty in patients with mild to moderate intermittent claudication (MIMIC) managed by supervised exercise, smoking cessation advice and best medical therapy: results from two randomised trials for stenotic femoropopliteal and aortoiliac arterial disease the MIMIC trial participants (See Appendix 1). / Greenhalgh, R. M.; Belch, J. J. F.; Brown, L. C. et al.
In: European Journal of Vascular and Endovascular Surgery, Vol. 36, No. 6, 2008, p. 680-688.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - The adjuvant benefit of angioplasty in patients with mild to moderate intermittent claudication (MIMIC) managed by supervised exercise, smoking cessation advice and best medical therapy

T2 - results from two randomised trials for stenotic femoropopliteal and aortoiliac arterial disease the MIMIC trial participants (See Appendix 1)

AU - Greenhalgh, R. M.

AU - Belch, J. J. F.

AU - Brown, L. C.

AU - Gaines, P. A.

AU - Gao, L.

AU - Reise, J. A.

AU - Thompson, S. G.

AU - MIMIC Trial Participants

PY - 2008

Y1 - 2008

N2 - Background: Uncertainty exists on whether there is adjuvant benefit of percutaneous transluminal angioplasty (PTA) over supervised exercise and best medical therapy in the treatment of intermittent claudication.Methods: Patients with symptoms of stable mild to moderate intermittent claudication (MIMIC) were randomised in two multi-centre trials, for femoropopliteal and aortoiliac arterial disease, to receive either PTA or no PTA against a background of supervised exercise and best medical therapy and followed up for 24 months. Initial claudication distance (ICD) and absolute walking distance (AWD) on treadmill were compared between randomised groups adjusting for the corresponding measure at baseline. Secondary outcomes included ankle-brachial pressure index (ABPI) and quality of life.Findings: A total of 93 patients were randomised into the femoropopliteal trial (48 into PTA) and 34 into the aortoiliac trial (19 to PTA). The mean (standard deviation, SD) age was 66(9) years for the femoropopliteal trial (63% male) and 63(9) for the aortoiliac trial (65% mate). At 24 months, there were significant improvements in both AWD and ICD in the PTA groups for both trials. The adjusted AWD was 38% greater in the PTA group for the femoropopliteal trial (95%; CI 1-90) (p = 0.04) and 78% greater in the PTA group for the aortoiliac trial (95%; CI 0-216) (p = 0.05). Further benefits were demonstrated for ABPI but not for quality of life.Interpretation: PTA confers adjuvant benefit over supervised exercise and best medical therapy in terms of walking distances and ABPI 24 months after PTA in patients with stable mild to moderate intermittent claudication. (C) 2008 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

AB - Background: Uncertainty exists on whether there is adjuvant benefit of percutaneous transluminal angioplasty (PTA) over supervised exercise and best medical therapy in the treatment of intermittent claudication.Methods: Patients with symptoms of stable mild to moderate intermittent claudication (MIMIC) were randomised in two multi-centre trials, for femoropopliteal and aortoiliac arterial disease, to receive either PTA or no PTA against a background of supervised exercise and best medical therapy and followed up for 24 months. Initial claudication distance (ICD) and absolute walking distance (AWD) on treadmill were compared between randomised groups adjusting for the corresponding measure at baseline. Secondary outcomes included ankle-brachial pressure index (ABPI) and quality of life.Findings: A total of 93 patients were randomised into the femoropopliteal trial (48 into PTA) and 34 into the aortoiliac trial (19 to PTA). The mean (standard deviation, SD) age was 66(9) years for the femoropopliteal trial (63% male) and 63(9) for the aortoiliac trial (65% mate). At 24 months, there were significant improvements in both AWD and ICD in the PTA groups for both trials. The adjusted AWD was 38% greater in the PTA group for the femoropopliteal trial (95%; CI 1-90) (p = 0.04) and 78% greater in the PTA group for the aortoiliac trial (95%; CI 0-216) (p = 0.05). Further benefits were demonstrated for ABPI but not for quality of life.Interpretation: PTA confers adjuvant benefit over supervised exercise and best medical therapy in terms of walking distances and ABPI 24 months after PTA in patients with stable mild to moderate intermittent claudication. (C) 2008 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

KW - Percutaenous transluminal angioplasty

KW - Intermittent claudication

KW - Femoropopliteal

KW - Aortoiliac

KW - Occlusive or stenotic arterial disease

KW - Walking distance

KW - Treadmill test

KW - ABPI

KW - PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY

KW - SUPERFICIAL FEMORAL-ARTERY

KW - NITINOL STENT IMPLANTATION

KW - WALKING DISTANCE

KW - LESIONS

U2 - 10.1016/j.ejvs.2008.10.007

DO - 10.1016/j.ejvs.2008.10.007

M3 - Article

C2 - 19022184

SN - 1078-5884

VL - 36

SP - 680

EP - 688

JO - European Journal of Vascular and Endovascular Surgery

JF - European Journal of Vascular and Endovascular Surgery

IS - 6

ER -

Greenhalgh RM, Belch JJF, Brown LC, Gaines PA, Gao L, Reise JA et al. The adjuvant benefit of angioplasty in patients with mild to moderate intermittent claudication (MIMIC) managed by supervised exercise, smoking cessation advice and best medical therapy: results from two randomised trials for stenotic femoropopliteal and aortoiliac arterial disease the MIMIC trial participants (See Appendix 1). European Journal of Vascular and Endovascular Surgery. 2008;36(6):680-688. doi: 10.1016/j.ejvs.2008.10.007