Quality of Life after Balloon Angioplasty versus Stent Implantation in the Superficial Femoral Artery: Findings from a Randomized Controlled Trial

2007 ◽  
Vol 14 (4) ◽  
pp. 431-437 ◽  
Author(s):  
Schila Sabeti ◽  
Alfa Czerwenka-Wenkstetten ◽  
Petra Dick ◽  
Oliver Schlager ◽  
Jasmin Amighi ◽  
...  

Purpose: To investigate whether primary nitinol stenting in the superficial femoral artery (SFA) is beneficial to patients' quality of life (QoL). Methods: One hundred four patients (55 men; mean age 66±19 years) with chronic limb ischemia and SFA disease were randomly assigned to primary stent implantation (n=51) or balloon angioplasty (n=53) with optional stenting for a suboptimal angioplasty result (17 of 53). QoL was measured by the SF-36 questionnaire at baseline and at 3, 6, and 12 months post intervention. Results: QoL was significantly improved post intervention and up to 12 months in both treatment groups. Significant inverse associations were observed between QoL parameters and restenosis. Comparing primary stenting (n=51) versus balloon angioplasty with optional stenting (n=53) by the intention to treat, no significant differences in QoL were observed. Analyses of stented patients (n=68) versus balloon angioplasty (n=36) patients, however, demonstrated significantly improved measures of QoL after stenting. Conclusion: Endovascular revascularization of SFA disease improves QoL, and restenosis negatively affects QoL outcomes. After stent implantation, whether primary or secondary, QoL was significantly ameliorated compared to balloon angioplasty alone. However, it remains to be proven in larger cohorts whether primary stenting yields a QoL benefit compared to balloon angioplasty with optional secondary stenting.

2020 ◽  
Author(s):  
Julie Lorraine O'Sullivan ◽  
Sonia Lech ◽  
Paul Gellert ◽  
Ulrike Grittner ◽  
Jan-Niklas Voigt-Antons ◽  
...  

Abstract Background: Non-pharmacological interventions (NPI) can improve cognitive and non-cognitive symptoms in nursing home residents living with dementia. However, delivery of suitable NPI can be challenging in everyday nursing home settings. Internet and communication technologies (ICT) may be promising tools for supporting NPI delivery in nursing homes. Methods: A two-arm cluster-randomised controlled trial was conducted to investigate global and momentary effects of a novel ICT-based NPI for nursing home residents with dementia. Ten nursing homes were randomly allocated to the tablet-based intervention (TBI) or conventional activity sessions (CAS) group (each with five nursing homes) between April 2016 and May 2017. A total of N = 162 participants received either regular TBI (n = 80) or CAS (n = 82) over a period of eight weeks. Linear mixed models were used to analyse group differences regarding the primary outcome apathy (AES-I), and secondary outcomes quality of life (QOL-AD, QUALIDEM), neuropsychiatric (NPI-NH, psychotropic medication) and depressive symptoms (GDS). Ecological Momentary Assessments (EMA) of quality of life were also conducted in both groups before and after each activity session.Results: No significant group difference in the change of apathy (AES-I score, primary outcome) was found post intervention (mean group difference: B = .19; 95% CI: -3.90 to 4.28, p = .93). Regarding secondary outcomes, a reduction of psychotropic medication was found for TBI compared to CAS (B = .42; 95% CI: .15 to .69, p < .01). Further analyses revealed a post-intervention improvement of informant-rated quality of life across both groups (B = 3.69; 95% CI: .68 to 6.69, p = .02). Analysis of EMA also rendered short-term post-session improvements of quality of life in the CAS group (B = .43; 95% CI: .30 to .57, p < .001). Conclusions: These findings suggest that NPI involving individually tailored activities have a beneficial impact on quality of life in nursing home residents with dementia. Although we found no clear advantage of TBI compared to CAS, ICT have the potential to support NPI delivery and facilitate regular assessments of fluctuating momentary states in nursing home residents with dementia. Trial registration: The trial was retrospectively registered with the ISRCTN registry (Trial registration number: ISRCTN98947160) on 01/09/2016 http://www.isrctn.com/ISRCTN98947160.


2020 ◽  
Vol 47 (4) ◽  
pp. 451-462
Author(s):  
Júlia Caetano Martins ◽  
Sylvie Nadeau ◽  
Larissa Tavares Aguiar ◽  
Aline Alvim Scianni ◽  
Luci Fuscaldi Teixeira-Salmela ◽  
...  

BACKGROUND: Impaired mobility is related to low physical activity (PA) levels observed after stroke. Therapeutic approaches, such as task-specific circuit training (TSCT), used to improve mobility in individuals with stroke, could also improve PA levels. OBJECTIVE: To investigate the efficacy of TSCT, focused on both upper (UL) and lower (LL) limbs, in improving PA levels and mobility (primary outcomes), as well as muscle strength, exercise capacity, and quality of life (secondary outcomes) in subjects with stroke. METHODS: A randomized controlled trial with 36 subjects with chronic stroke was conducted. Experimental group: TSCT, involving both UL and LL. Control group: global stretching, memory exercises, and education sessions. Both groups received 60 minute sessions/week over 12 weeks. Outcomes were measured at baseline, post-intervention and 16 week follow-up. RESULTS: No changes were found for primary and secondary outcomes (0.11≤p≤0.99), except for quality of life, which improved in the experimental group post-intervention and 16 week follow-up (p = 0.02). CONCLUSION: TSCT focused on both UL and LL was not effective on PA levels and mobility of individuals with chronic stroke, however, improvements in quality of life were observed. Since this is the first study to investigate this combined training aimed at improving PA levels, future studies are necessary to better understand the impact of this type of intervention.


2019 ◽  
Vol 41 part 2 (2) ◽  
pp. 35-38
Author(s):  
V. I. Rusyn ◽  
V. V. Korsak ◽  
V. V. Rusyn ◽  
F. V. Horlenco ◽  
V. M. Dobosh

of the study. To improve the treatment outcomes of patients with occlusion-stenotic lesions of the femoral-popliteal-tibial segment, long-term results of the profundafemorispopliteal autologous vein bypass surgery have been studied. Material and methods. In the surgical clinic of A. Novak Regional Clinical Hospital during the last 10 years has been performed 300 isolated profundoplasty at chronic limb ischemia. In 16 p atients w ith d eep femoral popliteal autologous vein bypass, a distal segment of arteria profunda femoris was used as the «tidal» artery, which varied from 0,51 to 0,63 in diameter (0,58 cm in average). Results. In the immediate and long-term follow-up period, no thrombosis of profunda femoris popliteal autologous vein shunt was observed in 5 years. The ankle-brachial pressure index after surgery increases almost twice and approaches 0,9 on posterior tabial artery. The mean profunda popliteal collateral index score decreased to 0,301 ± 0,099 in all patients after surgery. If we compare the quality of life after profunda femoris popliteal autologous vein reconstruction, it should be noted that the quality of life in our patients before the operation was 21,8 ± 4,9 points, after the operation − 45,6 ± 4,9 points. Conclusion.Profundafemorispopliteal autologous vein bypass by a length of up to 15 cm provides blood supply to the limb with stenoticocclusive lesions of the femoral-popliteal-tibial segment, with the passage of at least one artery of the leg and the arteries of the pedis. Keywords: chronic limb ischemia; deep femoral artery, prufundoplasty.


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