Importance of Vascular Rehabilitation in the Treatment of Chronic Critical Limb Ischemia

Abstract

Exercise conditioning for peripheral arterial disease, despite being the treatment of choice for patients with intermittent claudication, is not commonly employed in Japan, in contrast with the extensive use of invasive treatment. Furthermore, vascular rehabilitation (VR) for patients with chronic critical limb ischemia (CLI) is rarely performed. In this study, 10 patients with CLI after vascular reconstruction (REC: bypass surgery or percutaneous peripheral intervention) who were enrolled in a 12-week comprehensive VR program (supervised treadmill exercise or alternative walking exercise, physical therapy, and consultation regarding daily activities), were compared with 10 patients with CLI who were treated with REC but did not receive VR. The patency rate and limb salvage rate did not differ between the VR group and the REC group, but improvements in walking ability, SF-36 health survey scores and B-type natriuretic peptide levels were greater in the VR group than in the REC group. This suggests that VR is an essential treatment for CLI patients in order to obtain improvement in their quality of life.