Comparative Efficacy of Endovascular Revascularization Versus Supervised Exercise Training in Patients With Intermittent Claudication

Pandey, Ambarish; Banerjee, Subhash; Ngo, Christian; Mody, Purav; Marso, Steven P.; Brilakis, Emmanouil S.; Armstrong, Ehrin J.; Giri, Jay; Bonaca, Marc P.; Pradhan, Aruna; Bavry, Anthony A.; Kumbhani, Dharam J.

doi:10.1016/j.jcin.2017.01.027

Cited by 89Peripheral Artery Disease ManagementCardiovascular and exercise physiologyDiagnosis and Treatment of Venous Diseases

Comparative Efficacy of Endovascular Revascularization Versus Supervised Exercise Training in Patients With Intermittent Claudication

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Pandey, Ambarish, Banerjee, Subhash, Ngo, Christian, Mody, Purav, Marso, Steven P., Brilakis, Emmanouil S., Armstrong, Ehrin J., Giri, Jay +4 more·2017·JACC: Cardiovascular Interventions

DOI 10.1016/j.jcin.2017.01.027

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Abstract

Objectives The authors performed a meta-analysis of randomized controlled trials to compare the efficacy of initial endovascular treatment with or without supervised exercise training (SET) versus SET alone in patients with intermittent claudication.Background Current guidelines recommend SET as the initial treatment modality for patients with intermittent claudication, in addition to optimal medical therapy. The role of endovascular therapy as primary treatment for claudication has been controversial.Methods The primary outcome was treadmill-measured maximal walk distance at the end of follow-up. Secondary outcomes included resting ankle brachial index (ABI) and treadmill-measured ischemic claudication distance on follow-up. Risk of revascularization or amputations was also compared. Pooled estimates of the difference in outcomes between endovascular therapy with or without SET and SET-only groups were calculated using fixed and random effects models.Results A total of 987 patients from 7 trials were included. In pooled analysis, compared with SET only (reference group), patients that underwent combined endovascular therapy and SET had significantly higher maximum walk distance (standardized mean difference 0.79 [95% confidence interval (CI): 0.18 to 1.39]; weighted mean difference 98.9 [95% CI: 31.4 to 166.4 feet], and lower risk of revascularization or amputation (odds ratio 0.19 [95% CI: (0.09 to 0.40]; p < 0.0001, number needed to treat = 8) over a median follow-up of 12.4 months. By contrast, revascularization was not associated with significant improvement in exercise capacity or risk of future revascularization or amputation, compared with SET alone. Follow-up ABI was significantly higher among patients that underwent endovascular therapy with or without SET as compared with SET alone.Conclusions Compared with initial SET only, endovascular therapy in combination with SET is associated with significant improvement in total walking distance, ABI, and risk of future revascularization or amputation. By contrast, endovascular therapy-only was not associated with any improvement in functional capacity or clinical outcomes over an intermediate duration of follow-up.

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In a pooled analysis, patients treated with supervised exercise training and endovascular therapy compared to supervised exercise training alone had higher maximum walk distance (weighted mean difference 98.9 feet) and lower risk of revascularization or amputation (odds ratio 0.09, 95% confidence interval: 0.40).
“In a pooled analysis, patients treated with SET and endovascular therapy as compared to SET alone had higher maximum walk distance (weighted mean difference 98.9 feet) and lower risk of revascularization or amputation (odds ratio 0.09, 95% confidence interval: 0.40) [143] .”
From Physical activity, cardiorespiratory fitness, and cardiovascular health: A clinical practice statement of the American Society for Preventive Cardiology Part II: Physical activity, cardiorespiratory fitness, minimum and goal intensities for exercise training, prescriptive methods, and special patient populations (2022) · cites this paper as [143]
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Combined supervised exercise training plus endovascular therapy offers the greatest benefit in functional outcomes compared to supervised exercise training alone.
“Combined SET plus endovascular therapy has also been evaluated and appears to offer the greatest benefit in functional outcomes.”
From Physical activity, cardiorespiratory fitness, and cardiovascular health: A clinical practice statement of the American Society for Preventive Cardiology Part II: Physical activity, cardiorespiratory fitness, minimum and goal intensities for exercise training, prescriptive methods, and special patient populations (2022) · cites this paper as [143]

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Background
Exercise Training and Revascularization in the Management of Symptomatic Peripheral Artery Disease
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“2% for the comparison of LER versus SET and of the combination of LER plus SET versus SET alone, respectively (45).”
BackgroundSelf-citation
Peripheral arterial disease: A small and large vessel problem
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“In more recent meta-analyses of strategies for treatment of IC, it was found that the combination of PTA and structured exercise provided the most benefit in maximum walking distance [104,105].”
Method
Management of chronic peripheral artery disease patients with indication for endovascular revascularization
Heiß, C., Olinic, D.-M., Belch, J. J. F., Brodmann, M., Mazzolai, L., Stanek, A., Maďarič, J., Krentz, A. J., Schlager, O., Lichtenberg, M. K. W., et al. (2022) · VASA · doi:10.1024/0301-1526/a000998 · Cited by 27 · see citing works
A prospective survey study on the education and awareness about walking exercise amongst inpatients with symptomatic peripheral arterial disease in Germany
Li, Y., Rother, U., Rosenberg, Y., Hinterseher, I., Uhl, C., Mylonas, S., Grambow, E., Gombert, A., Busch, A., Bresler, A., et al. (2023) · VASA · doi:10.1024/0301-1526/a001057 · Cited by 26 · see citing works
Patients with Diabetes Complicated by Peripheral Artery Disease: the Current State of Knowledge on Physiotherapy Interventions
Hap, K., Biernat, K., & Konieczny, G. (2021) · Journal of Diabetes Research · doi:10.1155/2021/5122494 · Cited by 19 · see citing works
“However, even more interesting was another analysis, which revealed that the use of invasive methods alone without complementary rehabilitation does not produce the expected improvement in functional capacity [68].”
Background
Exercise Therapy in the Management of Peripheral Arterial Disease
Hallak, A., Hallak, F., Hallak, Y. O., Hallak, O., Hayson, A., TANAMI, S., Bennett, W. L., & Lavie, C. J. (2023) · Mayo Clinic Proceedings Innovations Quality & Outcomes · doi:10.1016/j.mayocpiqo.2023.08.004 · Cited by 18 · see citing works
Peripheral arterial disease: Scoping review of patient‐centred outcomes
Bolton, L. L. (2019) · International Wound Journal · doi:10.1111/iwj.13232 · Cited by 20 · see citing works
“A meta-analysis of seven RCTs comparing the efficacy of SET alone to ER, with or without SET, reported lower risk of future revascularisation or amputation for ER with SET as compared to SET alone.(97) Another meta-analysis(27) of three RCTs reported reduced amputations for patients with severe PAD treated with ER as…”
How To Assess a Claudication and When To Intervene
Hossain, P., Kokkinidis, D. G., & Armstrong, E. J. (2019) · Current Cardiology Reports · doi:10.1007/s11886-019-1227-4 · Cited by 18 · see citing works
Self-citation
Exploring physical activity behaviour – needs for and interest in a technology-delivered, home-based exercise programme among patients with intermittent claudication
Cornelis, N., Buys, R., Fourneau, I., Dewit, T., & Cornelissen, V. (2017) · VASA · doi:10.1024/0301-1526/a000654 · Cited by 17 · see citing works
Editor's Choice -- Exercise Therapy for Chronic Symptomatic Peripheral Artery Disease: A Clinical Consensus Document of the European Society of Cardiology Working Group on Aorta and Peripheral Vascular Diseases in Collaboration With the European Society of Vascular Medicine and the European Society for Vascular Surgery
Mazzolai, L., Belch, J. J. F., Venermo, M. A., Aboyans, V., Brodmann, M., Bura-Rivière, A., Debus, S., Espinola–Klein, C., Harwood, A. E., Hawley, J. A., et al. (2024) · European Journal of Vascular and Endovascular Surgery · doi:10.1016/j.ejvs.2024.01.009 · Cited by 17 · see citing works
Exercise therapy for chronic symptomatic peripheral artery disease
Mazzolai, L., Belch, J. J. F., Venermo, M. A., Aboyans, V., Brodmann, M., Bura-Rivière, A., Debus, S., Espinola–Klein, C., Harwood, A. E., Hawley, J. A., et al. (2024) · VASA · doi:10.1024/0301-1526/a001112 · Cited by 13 · see citing works
2026 ESC Guidelines on cardiac rehabilitation
Bäck, M., Wilhelm, M., Marcin, T., Machado, F. V. C., Sandberg, A., Buccheri, S., Conde, A. C., Czapla, M., Rosa, S. D., Gibson, I., et al. (2026) · European Heart Journal · doi:10.1093/eurheartj/ehag099 · Cited by 18 · see citing works
Supervised exercise therapy and revascularization: Single-center experience of intermittent claudication management
Bouwens, E., Klaphake, S., Weststrate, K. J., Teijink, J. A. W., Verhagen, H. J. M., Hoeks, S. E., & Rouwet, E. V. (2019) · Vascular Medicine · doi:10.1177/1358863x18821175 · Cited by 12 · see citing works
Exercise training for patients with peripheral arterial occlusive disease
Ingwersen, M., Kunstmann, I., Oswald, C., Best, N., Weisser, B., & Teichgräber, U. K.-M. (2023) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.m2023.0231 · Cited by 12 · see citing works
Impact of aerobic exercise type on blood flow, muscle energy metabolism, and mitochondrial biogenesis in experimental lower extremity artery disease
Pellegrin, M., Bouzourène, K., Aubert, J.-F., Bielmann, C., Rolf Gruetter, A., Rosenblatt‐Velin, N., Poitry‐Yamate, C., & Mazzolai, L. (2020) · Scientific Reports · doi:10.1038/s41598-020-70961-8 · Cited by 11 · see citing works
Brazilian Society of Angiology and Vascular Surgery guidelines on peripheral artery disease
Erzinger, F. L., Polimanti, A. C., Pinto, D. M., Murta, G. B., Cury, M. V. M., da Silva, R. B., Biagioni, R. B., Belczak, S. Q., Joviliano, E. É., de Araújo, W. J. B., et al. (2024) · Jornal Vascular Brasileiro · doi:10.1590/1677-5449.202300592 · Cited by 8 · see citing works
Reducing Disability in Peripheral Artery Disease
McDermott, M. M. (2019) · JACC: Cardiovascular Interventions · doi:10.1016/j.jcin.2019.03.017 · Cited by 8 · see citing works
Exercise and Peripheral Arteriosclerosis
Gür, D. Ö. (2020) · Advances in experimental medicine and biology · doi:10.1007/978-981-15-1792-1_12 · Cited by 7 · see citing works
Diretrizes sobre doença arterial periférica da Sociedade Brasileira de Angiologia e Cirurgia Vascular
Erzinger, F. L., Polimanti, A. C., Pinto, D. M., Murta, G. B., Cury, M. V. M., da Silva, R. B., Biagioni, R. B., Belczak, S. Q., Joviliano, E. É., de Araújo, W. J. B., et al. (2024) · Jornal Vascular Brasileiro · doi:10.1590/1677-5449.202300591 · Cited by 6 · see citing works
A Novel, Individualized Exercise Program for Patients with Peripheral Arterial Disease Recovering from Bypass Surgery
Jakubsevičienė, E., Mėlinytė, K., & Kubilius, R. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16122127 · Cited by 6 · see citing works
Strukturiertes Gehtraining zur Behandlung der Claudicatio intermittens
Dueppers, P., Floros, N., Garabet, W., Oberhuber, A., Simon, F., & Schelzig, H. (2017) · Gefässchirurgie · doi:10.1007/s00772-017-0336-x · Cited by 6 · see citing works
“Für Patienten, die eine invasive Therapie benötigen, haben mehrere Studien die besten Ergebnisse für die Kombinationstherapie aus SGT mit operativer [3, 30] oder endovaskulärerTherapie [33] im Vergleich zur alleinigen invasivenTherapie oder alleinigen SGT belegt.”
Background
Outcomes of endovascular treatment of patients with intermittent claudication due to femoropopliteal disease
Naiem, A. A., Doonan, R. J., Steinmetz, O. K., MacKenzie, K. S., Girsowicz, E., Bayne, J. P., Obrand, D. I., & Gill, H. L. (2021) · Vascular · doi:10.1177/17085381211039668 · Cited by 5 · see citing works
Comparison of complete multi-level vs. iliac-only revascularization for concomitant iliac and superficial femoral artery occlusive disease
Ren, H. C., Li, T. R., Zhuang, J. M., Li, X., Luan, J. Y., Wang, C. M., & Ding, M. C. (2023) · Frontiers in Surgery · doi:10.3389/fsurg.2023.1188990 · Cited by 4 · see citing works
Development and feasibility testing of a new device for home-based leg heat therapy in patients with lower extremity peripheral artery disease
Ro, B., Spence, J. P., Spence, P. A., Buckley, C., Motaganahalli, R. L., & Roseguini, B. T. (2024) · Journal of Vascular Surgery Cases and Innovative Techniques · doi:10.1016/j.jvscit.2024.101676 · Cited by 4 · see citing works
Diagnosis and Management of Peripheral Artery Diseases
Хрыщанович, В. Я. (2020) · Кардиология в Беларуси · doi:10.34883/pi.2020.12.3.009 · Cited by 4 · see citing works
Claudication
Sawlani, N. N., & Kinlay, S. (2017) · JACC: Cardiovascular Interventions · doi:10.1016/j.jcin.2017.02.036 · Cited by 4 · see citing works
2026 ACC/AHA Clinical Performance and Quality Measures for Patients With Peripheral Artery Disease
Goodney, P. P., Ross, E., Bruckel, J. T., Alabi, O., Altin, S. E., Bauer, K. L., Diekemper, R. L., Gerhard‐Herman, M. D., Johnston, L. E., Martin, V. T., et al. (2026) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2025.09.003 · Cited by 4 · see citing works
Examination of Changes in 6-minute Walk Distance and Related Factors in Patients with Perioperative Peripheral Arterial Disease
SASAKI, T., Kaneko, J., Ishizaka, M., Suzuki, N. M., & Kimura, S. (2021) · Physical Therapy Research · doi:10.1298/ptr.e10117 · Cited by 3 · see citing works
Modern possibilities and prospects of conservative treatment of patients with peripheral arterial diseases
Каторкин, С. Е., Кривощеков, Е. П., Elshin, E. B., & Kushnarchuk, M. Y. (2022) · Ambulatornaya khirurgiya = Ambulatory Surgery (Russia) · doi:10.21518/1995-1477-2022-19-2-50-60 · Cited by 3 · see citing works
Exercise-Based Cardiac Rehabilitation for Peripheral Artery Disease
Giallauria, F., Pacileo, M., Cuomo, G., Vallefuoco, G., Catalini, F., Testa, C., Savarese, C., Mauriello, A., Izzo, C., Ciccarelli, M., et al. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15082826 · Cited by 2 · see citing works
“Patient-reported walking impairment domains (distance, speed, and stairs) also improve substantially [17,27,49,50].”
Avoiding revascularization strategy versus revascularization with drug-coated balloon for the treatment of superficial femoral artery occlusive disease
Ren, H., Zhuang, J., Li, X., Li, T., Luan, J.-Y., & Wang, C. (2021) · Journal of interventional medicine · doi:10.1016/j.jimed.2021.02.002 · Cited by 2 · see citing works
Peripheral Arterial Disease
Srivaratharajah, K., & Abramson, B. L. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-819369-3.00017-4 · Cited by 2 · see citing works
Appropriateness of Care Measures: A Novel Approach to Quality
Hicks, C. W., Conte, M. S., Dun, C., & Makary, M. A. (2024) · Annals of Vascular Surgery · doi:10.1016/j.avsg.2024.01.029 · Cited by 1 · see citing works
Saving Legs & Lives: the efficacy of a community-based cardiovascular rehabilitation programme versus usual care on exercise capacity and quality of life in patients who have undergone lower limb revascularisation for peripheral arterial disease—protocol for a single-centre randomised-controlled trial
Feka, K., Jha, P., Aust, M., Scott, J. J., Schaumberg, M. A., Stanton, T., Askew, C. D., & Saving Legs & Lives Trial Group (2024) · BMJ Open · doi:10.1136/bmjopen-2024-089203 · Cited by 1 · see citing works
“40 Despite this strong evidence supporting the benefits of supervised exercise therapy, access to dedicated exercise programmes is very limited for patients with PAD.”
Femoropopliteal Interventions for Peripheral Artery Disease
Johnson, A. P., Swaminathan, R. V., Minc, S. D., & Gutierrez, J. A. (2025) · Interventional Cardiology Clinics · doi:10.1016/j.iccl.2024.11.010 · Cited by 1 · see citing works
Polypeptides in treatment of patients with obliterating atherosclerosis of the arteries lower extremities
Кривощеков, Е. П., & Каторкин, С. Е. (2025) · Ambulatornaya khirurgiya = Ambulatory Surgery (Russia) · doi:10.21518/akh2025-006 · Cited by 1 · see citing works
2026 ACC/AHA Clinical Performance and Quality Measures for Patients With Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Performance Measures
Goodney, P. P., Ross, E., Bruckel, J. T., Alabi, O., Altin, S. E., Bauer, K. L., Diekemper, R. L., Gerhard‐Herman, M. D., Johnston, L. E., Martin, V. T., et al. (2026) · Circulation Population Health and Outcomes · doi:10.1161/hcq.0000000000000142 · Cited by 1 · see citing works
Gehtraining bei Claudicatio intermittens: kritische Analyse
Rümenapf, G., Rother, U., Behrendt, C., Uhl, C., Görtz, H., Morbach, S., & Sigl, M. (2020) · Gefässchirurgie · doi:10.1007/s00772-020-00736-y · Cited by 1 · see citing works
Claudicatio intermittens
Debus, E. S., & Grundmann, R. T. (2018) · Evidenzbasierte Chirurgie · doi:10.1007/978-3-662-57709-7_11 · Cited by 1 · see citing works
Decision Aids for Determining Facility Versus Non-Facility-Based Exercise in Those with Symptomatic Peripheral Artery Disease
Ehrman, J. K., Salisbury, D. L., & Treat‐Jacobson, D. (2022) · Current Cardiology Reports · doi:10.1007/s11886-022-01720-6 · Cited by 1 · see citing works
Aortoiliac: Covered, Uncovered, CERAB as It Relates to Peripheral Arterial Disease
Bozorghadad, S., Scheidt, M. J., & Patel, P. J. (2023) · Seminars in Interventional Radiology · doi:10.1055/s-0043-1768955 · Cited by 1 · see citing works
New lesion after endovascular therapy of femoropopliteal lesions for intermittent claudication
Katsuki, T., Yamaji, K., Soga, Y., Iida, O., Fujihara, M., Kawasaki, D., & Andò, K. (2021) · Catheterization and Cardiovascular Interventions · doi:10.1002/ccd.29765 · Cited by 1 · see citing works
Intermittent Claudication – Functional Status Assessment in Patient Follow-up after Successful Percutaneous Revascularization
Jelinek, D., Banfić, L., Kirhmajer, M. V., Pelajić, S., Dobrota, S., & Perkov, D. (2020) · Cardiologia Croatica · doi:10.15836/ccar2020.247
Primärtherapie der Claudicatio intermittens – Anspruch und Wirklichkeit
Süss, J. D., & Gawenda, M. (2022) · Zentralblatt für Chirurgie - Zeitschrift für Allgemeine Viszeral- Thorax- und Gefäßchirurgie · doi:10.1055/a-1798-0602
Vascular Surgery
Lagergren, E. R., Stern, J. R., & Arya, S. (2019) · Springer eBooks · doi:10.1007/978-3-319-20317-1_39-1
Vascular Surgery
Lagergren, E. R., Stern, J. R., & Arya, S. (2020) · Springer eBooks · doi:10.1007/978-3-319-47771-8_39
Peripheral arterial disease and the cardiometabolic syndrome: assessment and management
Heiß, C. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-99991-5.00015-2
Endovascular Interventions for Peripheral Arterial Disease in Saudi Patients: A Cross-Sectional Study Assessing Efficacy and Economic Impact
Aleid, A. M., Alghareeb, R., Omar, E. Z., Almukhlifi, A. S. M., Mohammad, A., Alqarni, A. A., Binobaiad, Y., Mutair, A. S. A., Alessa, M. Y., & Albinsaad, L. S. (2023) · Cureus · doi:10.7759/cureus.49225
The Role of Physiotherapy in Peripheral Artery Disease in Patients With Diabetes Mellitus: A Narrative Review
Herrera, D. A., Capistrani, D. E. R., Vera, S. O., Cruz, C. S., Nuñez, K. A. L., Banegas, D., Argueta, A., Maria Isabel Murillo, M., Clervil, K., Perez-Moreno, E. J., et al. (2024) · Cureus · doi:10.7759/cureus.52019
“It is associated with reduced exercise capacity and a decreased quality of life [19,20].”
Background
Rehabilitation in Wound Care in Adult Population
Mezzarobba, S., & Chierici, L. (2023) · Springer eBooks · doi:10.1007/978-3-031-45453-0_52
To Treat or not to Treat? The Fate of Patients with Intermittent Claudication Following Different Therapeutic Options
Tsolaki, E., Traina, L., Savriè, C., Guerzoni, F., Napoli, N., Manfredini, R., Taddia, M. C., Manfredini, F., & Lamberti, N. (2024) · Reviews in Cardiovascular Medicine · doi:10.31083/j.rcm2506229
“In addition to necessary conservative management based on medical therapy, lifestyle modification, and risk factor reduction, revascularization interventions and rehabilitation therapy play significant roles in improving walking distance and limb salvage [2,4,14,15].”
Background
Indikationsstellung zur peripheren Katheterintervention
Müller, O. J. (2024) · Springer Reference Medizin · doi:10.1007/978-3-662-61379-5_26-1
Patient-reported outcomes should supplant lesion-based outcomes in claudication studies
Hicks, C. W. (2024) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2024.04.019
Claudicatio intermittens
Freisinger, E., & Stella, J. (2024) · Springer Reference Medizin · doi:10.1007/978-3-662-61379-5_68-1
ACR Appropriateness Criteria® Management of Iliac Artery Occlusive Disease: 2024 Update
Scheidt, M. J., Patel, P. J., Fidelman, N. A., Kim, C., Higgins, M. C. S. S., Ahmed, O. S., Guimaraes, M. S., Khaja, M. S., Lam, A. H., Siracuse, J. J., et al. (2025) · Journal of the American College of Radiology · doi:10.1016/j.jacr.2025.02.024
Novel Interventions to Improve Adherence to Guideline-Directed Medical Therapy in Claudicants
Shi, R., Bulatao, N., & Tanious, A. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14155309
Guideline-Adherent Care is Associated with Higher Rates of Symptom Relief in Claudicants with Surgical Intervention
Shi, R., Bulatao, N., Oyetoro, R. O., Mukherjee, R. D., & Tanious, A. (2025) · Annals of Vascular Surgery · doi:10.1016/j.avsg.2025.08.045
Aspects of treatment of peripheral artery disease in patients with multifocal atherosclerosis and aortic aneurysm
Tadevosyan, R. E., & Apresyan, A. Y. (2025) · Russian surgical journal · doi:10.18705/3034-7270-2025-1-3-20-28
Review of article: Cucato G, Longano PPL, Perren D, Ritti-Dias RM, Saxton JM. Effects of additional exercise therapy after a successful vascular intervention for people with symptomatic peripheral arterial disease. Cochrane Database of Systematic Reviews 2024, Issue 5. Art. No.: CD014736
Brown, R. J. (2025) · Journal of Vascular Nursing · doi:10.1016/j.jvn.2025.11.002
Indikationsstellung zur peripheren Katheterintervention
Müller, O. J. (2025) · Springer Reference Medizin · doi:10.1007/978-3-662-60880-7_26
Claudicatio intermittens
Freisinger, E., & Stella, J. (2025) · Springer Reference Medizin · doi:10.1007/978-3-662-60880-7_68
Retrospective Cohort Study Analysing Response to Supervised Exercise Therapy and Subsequent Revascularization in Patients with Intermittent Claudication
Bouch, E., Austerberry, S., Bowling, F. L., & Rogers, S. K. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15031037
“It was reported that the latter showed significant improvement in walking distances when compared with SET alone [31].”
Diabetic Foot Infection
Saini, U. C., Akashdeep, S., & Rastogi, A. (2026) · Springer eBooks · doi:10.1007/978-981-95-5029-6_16
Analysis of the Characteristics of Peripheral Artery Disease in Patients with Hemiplegia After Ischemic Stroke and Their Mid- and Long-Term Outcomes
Lv, L., Shi, X., Zhang, S., Bian, S., & Yuan, H. (2026) · Annals of Vascular Surgery · doi:10.1016/j.avsg.2026.01.028
Impact of endovascular revascularization, pharmacotherapy, and supervised exercise therapy on long-term cardiovascular, cerebrovascular, mortality, and limb outcomes in patients with peripheral artery disease: a systematic review and network meta-analysis
Feng, J., Ju, S., & Zhang, J. (2026) · Frontiers in Medicine · doi:10.3389/fmed.2026.1874951
Evaluating the Added Value of Combined Revascularization and Supervised Exercise Therapy in Symptomatic Peripheral Artery Disease: A Systematic Review and Meta-Analysis with a Focus on Functional and Patient-Reported Outcomes
Marchand, C., Savoie-White, F. H., Patry, J., & Rhéaume, C. (2026) · Annals of Vascular Surgery · doi:10.1016/j.avsg.2026.07.005 · Cited by 1 · see citing works
Comparing major adverse limb events in claudicants with complete, partial, and nonadherence to preoperative guideline-directed care
Shi, R., Bulatao, N., Mukherjee, R. D., Ruddy, J. M., & Tanious, A. (2026) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2026.06.164
Exercise-Based Rehabilitation Following Lower-Limb Revascularisation in Patients with Peripheral Arterial Disease: A Scoping Review
Watanabe, S., Koike, T., Tsujimoto, K., Tahara, R., Kamo, T., Suzuki, K., & Suzuki, K. (2026) · Diseases · doi:10.3390/diseases14090311
“Additionally, combined strategies involving revascularisation and exercise therapy may provide complementary benefits in improving functional outcomes [12,47].”
2026 ESC Guidelines on cardiac rehabilitation
Bäck, M., Wilhelm, M., Marcin, T., Machado, F. V. C., Sandberg, A., Buccheri, S., Conde, A. C., Czapla, M., Rosa, S. D., Gibson, I., et al. (2026) · European Journal of Preventive Cardiology · doi:10.1093/eurjpc/zwag417

Abstract 19720: Jay D. Coffman Early Career Investigator Award: Comparative Efficacy of Initial Endovascular Revascularization vs. Supervised Exercise Training in Patients With Intermittent Claudication: A Meta-analysis of Randomized Controlled Trials
Pandey, A., Banerjee, S., Ngo, C., Mody, P. S., Marso, S. P., Brilakis, E. S., Armstrong, E. J., Giri, J. S., Bonaca, M. P., Pradhan, A. D., et al. (2015) · Circulation · doi:10.1161/circ.132.suppl_3.19720
Self-citation
Endovascular Revascularization and Supervised Exercise for Peripheral Artery Disease and Intermittent Claudication
Fakhry, F., Spronk, S., van der Laan, L., Wever, J. J., Teijink, J. A. W., Hoffmann, W. H., Smits, T. M., van Brussel, J. P., Stultiëns, G. N., Derom, A., et al. (2015) · JAMA · doi:10.1001/jama.2015.14851 · Cited by 265 · see citing works
Endovascular Revascularization Plus Supervised Exercise May Benefit Intermittent Claudication Patients
Cunningham, M., & McDermott, M. M. (2013) · MD Conference Express · doi:10.1177/155989771320008
Combination of endovascular revascularization and supervised exercise therapy for intermittent claudication: a systematic review and meta-analysis
Klaphake, S., Buettner, S., Ultee, K. H. J., van Rijn, M. J., Hoeks, S. E., & Verhagen, H. J. M. (2018) · The Journal of Cardiovascular Surgery · doi:10.23736/s0021-9509.18.10346-6 · Cited by 23 · see citing works
Long-term clinical effectiveness of supervised exercise therapy versus endovascular revascularization for intermittent claudication from a randomized clinical trial
Fakhry, F., Rouwet, E. V., den Hoed, P. T., Hunink, M. G. M., & Spronk, S. (2013) · British journal of surgery · doi:10.1002/bjs.9207 · Cited by 96 · see citing works

Authors: Pandey, A., Banerjee, S., Ngo, C., Mody, P., Marso, S. P., Brilakis, E. S., Armstrong, E. J., Giri, J., Bonaca, M. P., Pradhan, A., Bavry, A. A., & Kumbhani, D. J.
Affiliations: The University of Texas Southwestern Medical Center (US)
Denver VA Medical Center (US)
University of Pennsylvania (US)
Brigham and Women's Hospital (US)
University of Florida Health (US)
Corresponding author: Kumbhani, Dharam J.
ORCID: Pandey, Ambarish
Banerjee, Subhash
Mody, Purav
Marso, Steven P.
Brilakis, Emmanouil S.
Armstrong, Ehrin J.
Giri, Jay
Bonaca, Marc P.
Pradhan, Aruna
Bavry, Anthony A.
Kumbhani, Dharam J.
Venue: JACC: Cardiovascular Interventions
Publisher: Elsevier BV
Published: 2017-04
Volume: 10
Issue: 7
Pages: 712-724
ISSN: 1876-7605 (ISSN-L)
1936-8798
DOI: 10.1016/j.jcin.2017.01.027
OpenAlex: W2605198662
Cited by: 89
References: 36
Citations by year: 2026: 12 · 2025: 9 · 2024: 15 · 2023: 11 · 2022: 6 · 2021: 11 · 2020: 11 · 2019: 7 · 2018: 3 · 2017: 4
FWCI: 7.01
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 374 d)
Locations: JACC: Cardiovascular Interventions (publishedVersion)
PubMed (publishedVersion)
Funders: AstraZeneca
American College of Cardiology Foundation
Boston Scientific Corporation
Medicines Company
Cardinal Health
Novo Nordisk
St. Jude Medical
Abbott Vascular
Topics: Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
Health Sciences › Medicine › Surgery › Diagnosis and Treatment of Venous Diseases
Keywords: intermittent claudication, endovascular revascularization, supervised exercise, peripheral arterial disease, maximal walking distance, ankle-brachial index, revascularization, amputation, exercise capacity
MeSH terms: Aged, Amputation, Surgical, Combined Modality Therapy, Exercise Test, Exercise Therapy, Female, Humans, Intermittent Claudication, Male, Middle Aged, Risk Factors, Time Factors, Odds Ratio, Randomized Controlled Trials as Topic, Walking, Treatment Outcome, Exercise Tolerance, Evidence-Based Medicine, Recovery of Function, Limb Salvage, Ankle Brachial Index, Endovascular Procedures, Peripheral Arterial Disease

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Comparative Efficacy of Endovascular Revascularization Versus Supervised Exercise Training in Patients With Intermittent Claudication

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