Health Composite Scores from the 12-item Short-Form Health Survey. Those randomized to the intervention group increased their 6-minute walk distance in meters significantly (357.4 to 399.8 vs 353.3 to 342.2 for those in the control group; mean difference, 53.5; P < .001). There were also increases in maximum treadmill walking time (intervention, 7.91 to 9.44 minutes vs control, 7.56 to 8.09 minutes; mean difference, 1.01 minutes; P ¼ .04). Accelerometer-measured physical activity over 7 days also increased in the intervention group vs the control group (P ¼ .03). There were also significant improvements in the Walking Impairment Questionnaire distance score (P ¼ .003) and Walking Impairment Questionnaire speed score (P ¼ .004).Comment: The study indicates that home-based exercise can be effective in patients with PAD. It does not indicate that home-based exercise has equal effectiveness to supervised exercise programs, because the two were not directly compared. Nevertheless, until supervised exercise becomes a benefit of insurance coverage, the data should encourage physicians to recommend home-based exercise therapy in their patients with PAD.

This trial did not show a significant difference in combined death and severe complications between EVAR and OR. Mortality for OR both in randomized patients and in cohort patients was lower than anticipated, which may be explained by optimization of logistics, preoperative CT imaging, and centralization of care in centers of expertise.

During 12 years of follow-up, there was no survival difference between patients who underwent open or endovascular abdominal aortic aneurysm repair, despite a continuously increasing number of reinterventions in the endovascular repair group. Endograft durability and the need for continued endograft surveillance remain key issues.

The mortality rate after open or endovascular AAA repair in carefully selected octogenarians seems acceptable but is higher than the mortality rate in younger patients. Long-term survival rates were acceptable, but small sample size, selection, and publication bias must be taken into account. Finally, selection criteria for successful surgery with low mortality and morbidity rates cannot be derived from the literature.

These retrospective data suggest that endografting of descending thoracic aneurysms can be performed with less peri-operative morbidity, at lower hospital costs, but with equal mid-term life expectancy, compared with open grafting.

Currently, objective SDM behaviour among vascular surgeons is limited, even though the presented disorders allow for SDM. Hence, SDM in vascular surgical consultations could be improved by increasing the patients' and surgeons' awareness and knowledge about the concept of SDM.

No abstract

Emergency EVAR continues to be a promising approach to reduce the high mortality of rAAA, but the incidence of spinal cord ischemia after endovascular treatment of rAAA was worrisome. Although the pathogenesis is most likely multifactorial, interruption of the hypogastric artery inflow appeared to have significant influence. In patients with aneurysmatic common iliac arteries, any effort should be made to minimize hypogastric occlusion time during the procedure and to maintain hypogastric artery inflow afterwards, either by the use of a bell-bottom iliac extension or by electing open repair.