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Surgery Research and Practice
Volume 2015, Article ID 960402, 10 pages
http://dx.doi.org/10.1155/2015/960402
Review Article

Comparing Supervised Exercise Therapy to Invasive Measures in the Management of Symptomatic Peripheral Arterial Disease

1Department of Vascular Surgery, Beaumont Hospital, Dublin 9, Ireland
2Department of Interventional Radiology, Beaumont Hospital, Dublin 9, Ireland
3Department of Human and Health Performance, Dublin City University, Dublin 9, Ireland

Received 1 June 2015; Revised 5 October 2015; Accepted 11 October 2015

Academic Editor: Miltiadis I. Matsagkas

Copyright © 2015 Thomas Aherne et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Peripheral arterial disease (PAD) is associated with considerable morbidity and mortality. Consensus rightly demands the incorporation of supervised exercise training (SET) into PAD treatment protocols. However, the exact role of SET particularly its relationship with intervention requires further clarification. While supervised exercise is undoubtedly an excellent tool in the conservative management of mild PAD its use in more advanced disease as an adjunct to open or endovascular intervention is not clearly defined. Indeed its use in isolation in this cohort is incompletely reported. The aim of this review is to clarify the exact role of SET in the management of symptomatic PAD and in particular to assess its role in comparison with or as an adjunct to invasive intervention. A systematic literature search revealed a total 11 randomised studies inclusive of 969 patients. All studies compared SET and intervention with monotherapy. Study results suggest that exercise is a complication-free treatment. Furthermore, it appears to offer significant improvements in patients walk distances with a combination of both SET and intervention offering a superior walking outcome to monotherapy in those requiring invasive measures.