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Table 3 Example of a consultation card for patients with intermittent claudication.

From: Improving shared decision-making in vascular surgery by implementing decision support tools: study protocol for the stepped-wedge cluster-randomised OVIDIUS trial

Frequently asked questions (Supervised) exercise therapy Endovascular treatment
(with or without stenting)
Surgery
(Endarterectomy or bypass)
What does the treatment entail? You will exercise on a treadmill (supervised by a physical therapist) to increase your overall and pain-free walking distance. You also receive weight training exercises to practice at home. A wire is inserted into the artery in your groin. Attached to this wire is a balloon. The balloon is inflated to reduce the narrowing. Sometimes, a tube is left behind to keep the artery open. ▪ With an ‘endarterectomy’ the artery is opened and the narrowing surgically removed.
▪ With a ‘bypass’ either one of your own veins or an artificial tube is used to bypass the narrowed artery.
You will also continue to take medication to prevent a heart attack or stroke. You will also continue to take medication to prevent a heart attack or stroke. You will also continue to take medication to prevent a heart attack or stroke.
What are the benefits of this treatment? Your general condition will improve due to exercise therapy. There are no treatment risks. Your complaints will be less immediately after endovascular treatment. Your complaints will be less immediately after surgery.
What are the main risks associated with the treatment? You will not have an immediate effect of exercise therapy. It takes about 3 to 6 months before you experience improvement. Some patients will not be able to walk completely pain-free after exercise therapy. You may suffer from a hematoma (bruise), a reduced kidney function, or the endovascular treatment might even worsen your complaints. You may suffer from a hematoma (bruise), a wound infection, or the surgery might even worsen your complaints.
What is the effect of the treatment? After 6 months of exercise therapy, patients like yourself are able to walk twice as far as before the exercise therapy. Two years after endovascular treatment, the walking distance is about the same as after exercise therapy only. Two years after surgery, the walking distance is about the same as after exercise therapy only.
Will I receive anaesthesia? No. Yes; local anaesthesia. Yes; general or local anaesthesia.
How long do I stay in the hospital? No hospital stay. Usually 1 to 2 days. Usually 1 week.
What is the risk of losing my leg (amputation)? 1 to 3 of 100 people (1–3%) with intermittent claudication have an amputation within 10 years. 1 to 3 of 100 people (1–3%) with intermittent claudication have an amputation within 10 years. 1 to 3 of 100 people (1–3%) with intermittent claudication have an amputation within 10 years.
What more should I need to know about intermittent claudication? Exercise therapy does not prevent worsening of the disease. In case of insufficient results, endovascular treatment and surgery are still possible. Endovascular treatment does not prevent worsening of the disease. Even if you have undergone this treatment, exercise therapy will remain helpful. Surgery does not prevent worsening of the disease.
Even if you have undergone surgery, exercise therapy will remain helpful.
What can I do myself? The most important things you can do to prevent worsening of the disease is to quit smoking, take plenty of exercise, healthy food, and live a healthy life. The most important things you can do to prevent worsening of the disease is to quit smoking, take plenty of exercise, healthy food, and live a healthy life. The most important things you can do to prevent worsening of the disease is to quit smoking, take plenty of exercise, healthy food, and live a healthy life.
  1. Authors: Department of Vascular Surgery Amsterdam UMC location AMC, Heart and Vascular Group, Dutch Society for Vascular Surgery
  2. Based on: most recently available literature
  3. Publication date: May 16, 2017
Treatment options for intermittent claudication. Use this consultation card if you want to talk to your health care professional about how to treat your blocked or narrowed leg arteries (medical term: ‘intermittent claudication’). This way you can decide with your doctor which option is best for you