Measures and determinants of outcome in conservative intermittent claudication treatment

This dissertation aimed to contribute to various aspects of the management of intermittent claudication. Through various studies it was investigated how treatment outcomes are best measured and how various patient characteristics determine the outcome of conservative treatment. One study showed that supervised exercise therapy leads to increased physical activity in this sedentary population. Furthermore, this thesis revealed that implementation of supervised exercise therapy as first treatment, as opposed to invasively opening up the blocked vessel through percutaneous transluminal angioplasty, would lead to a cost-savings of €6.500 per patient without detrimental effect on quality of life. Finally, through a prospective study it was found that patients achieve equal improvements in walking performance and health-related quality of life, regardless of the location or the extent of the arterial obstruction. All intermittent claudication patients should receive a trial of supervised exercise therapy before invasive treatment is considered.