Frans, F.A.

English

In this thesis, different aspects have been explored on the treatment and patient-reported outcomes(PROMs) of patients with different stages of peripheral arterial disease (PAD). The first part of this thesis focuses on treatment and PROMs in patients with Intermittent Claudication (IC); the second part is about PROMs after treatment in patients with Critical Limb Ischemia (CLI). In patients with IC we confirmed the reliability and validity of two PROMs, the Dutch version of the Vascular Quality of Life questionnaire (VascuQol, measuring quality of life(Qol)) and the Academic Medical Center Linear Disability Score (ALDS, measuring functional status (FS)). Furthermore, we found that instruments that take into account the perceived impairment, might better guide and evaluate treatment decisions than patients’ estimated walking distances or on a treadmill. A systematic review of studies regarding the relative effectiveness of Percutaneous Transluminal Angioplasty (PTA), (supervised) exercise therapy (S)ET or their combination for patients with IC concluded that in general the effectiveness of PTA and (S)ET was equivalent. As the benefit of SET was unclear in specifically patients with IC and an iliac artery obstruction, we presented the design of a multicenter randomised controlled trial including these patients randomly assigned to PTA or SET. Regarding patients with CLI we found that the ALDS it is a valuable and sophisticated instrument to measure changes in functional status in these patients. Finally, the last chapter introduced a novel method, the minimally important difference (MID) to better express the proportion of patients who clinically benefitted or deteriorated after treatment of CLI

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UvA-DARE is a service provided by the library of the University of Amsterdam (https://dare.uva.nl)UvA-DARE (Digital Academic Repository)Functional status and quality of life after treatment of peripheral arterial diseaseFrans, F.A.Publication date2013Link to publicationCitation for published version (APA):Frans, F. A. (2013). Functional status and quality of life after treatment of peripheral arterialdisease. [Thesis, fully internal, Universiteit van Amsterdam].General rightsIt is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s)and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an opencontent license (like Creative Commons).Disclaimer/Complaints regulationsIf you believe that digital publication of certain material infringes any of your rights or (privacy) interests, pleaselet the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the materialinaccessible and/or remove it from the website. Please Ask the Library: https://uba.uva.nl/en/contact, or a letterto: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. Youwill be contacted as soon as possible.Download date:09 Mar 2023Figures belonging to chaptersFigure 1 Flow diagram of patient inclusion.174CHAPTER 3Figure 2 Median pain-free walking distance (PFWD) and maximum walking distance (MWD).Figure 3 Distribution of estimated maximum walking distance (MWD) to MWD corridor.175CHAPTER 3FIGURES BELONGING TO CHAPTERS176Figure 1.  Flow diagram of articles included in the Systematic ReviewFigure 2.  Results of Maximum Walking Distance in aorto-iliac artery disease per studyCHAPTER 4177CHAPTER 4Figure 3.  Results of Initial Claudication Distance in aorto-iliac artery disease per studyFigure 4.Results of Ankle Brachial Index in aorto-iliac artery disease per studyFIGURES BELONGING TO CHAPTERS178Figure 5.  Results of Maximum Walking Distance in femoro-popliteal disease per studyFigure 6. Results of Initial Claudication Distance in femoro-popliteal artery disease per studyCHAPTER 4179Figure 7. Results of Ankle Brachial Index in femoro-popliteal  artery disease per studyFigure 8. Results of Maximum Walking Distance in mixed aorto-iliac and femoro-popliteal artery disease per studyCHAPTER 4FIGURES BELONGING TO CHAPTERS180CHAPTER 4Figure 9. Results of Initial Claudication Distance in mixed aorto-iliac and femoro-popliteal artery disease per studyFigure 10. Results of Ankle Brachial Index in mixed aorto-iliac and femoro-popliteal artery disease per study181CHAPTER 5Figure 1. Eligibility criteriaFigure 2.  Description of Supervised Exercise Therapy (SET)FIGURES BELONGING TO CHAPTERS182CHAPTER 5Figure 3. Timeline SUPER studyFigure 4. Primary and secondary outcomes after 1 year183CHAPTER 6Figure 1. ALDS scores and corresponding activitiesFigure 2. Flow diagram of studyFIGURES BELONGING TO CHAPTERS184CHAPTER 6Figure 3a. Primary and additional interventionsFigure 3b. Details on limb salvage or major amputation185FIGURES BELONGING TO CHAPTERSCHAPTER 6Figure 4a. ALDS scores baseline, 6 and 12 months after interventionFigure 4b. VascuQol sumscores baseline, 6 and 12 months after intervention186CHAPTER 7Figure 1. Minimally Important DifferenceFigure 1a. Flow diagram of study 187FIGURES BELONGING TO CHAPTERSCHAPTER 7Figure 2. Proportion of patients showing an (un)important benefit or deterloration

Functional status and quality of life after treatment of peripheral arterial disease

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Functional status and quality of life after treatment of peripheral arterial disease

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International Migration, Integration and Social Cohesion online publications