Cost-effectiveness of endovascular revascularization compared to supervised hospital-based exercise training in patients with intermittent claudication: A randomized controlled trial

Abstract

In conclusion, there was no significant difference in effectiveness between endovascular revascularization compared to supervised hospital-based exercise during 12-months follow-up, any gains with endovascular revascularization found were non-significant, and endovascular revascularization costs more than the generally accepted threshold willingness-to-pay value, which favors exercise.

Exercise-based interventions and health-related quality of life in intermittent claudication: a 20-year (1989–2008) review

“…It has been postulated that improvements in QoL and mental health may lag behind improvements in ambulatory function [9,11] and this may explain the limited change in SF-36 Role-Emotional and Mental Health domains. Patients in exercise programmes may also underestimate QoL because improvement occurs slowly and less noticeably than with interventions, such as revascularisation [13]. The prevalence of concomitant chronic illnesses such as diabetes, hypertension and coronary artery disease is very common in PAD and can impact on QoL [36,37].…”

“…Most studies used treadmill walking as the primary mode of exercise training [9,[11][12][13][14][15][16][17][18][19][20][21][22]. The most commonly reported duration of supervised exercise was twelve weeks [9,12,15,[17][18][19][20][21][23][24][25] (Table 1).…”

“…Programmes SF-36: Eleven of 16 studies [8,9,13,16,17,19,21,22,24,26,28] reported an improvement in SF-36 Physical Functioning following participation in supervised exercise. Improvements in Bodily Pain (6 studies) [9,16,17,19,21,22], Role-PAVK-86 detected improvements in pain and functional status but the PAVK-86 also detected improvement in the anxiety domain [21].…”

Screening and Basic Workup of a Patient with Peripheral Vascular Disease – A Primer of Physicians

“…12-week supervised exercise programs have been shown to improve exercise performance and quality of life in PAD [46]. They are also more cost-effective than endovascular revasculization, as is a stepped approach of exercise therapy followed by endovascular revascularization than revascularization alone [48,47]. Supervised exercise in a hospital or outpatient facility is recommended for all patients with PAD [49].…”

The Role of Supervised Exercise Therapy in Peripheral Arterial Obstructive Disease

“…At a willingness-to-pay threshold of this €40,000 SET seemed a cost-effective therapeutic option for patients with PAOD. In another randomized cost-effectiveness analysis SET was compared with endovascular revascularization (angioplasty with or without stenting) (44). This study was unfortunately underpowered so no significant difference was obtained.…”