Physical and psychological functioning of patients with chronic limb ischemia during a 1-year period after endovascular revascularization.

OBJECTIVE: Symptoms of peripheral artery disease (PAD) and patients' physical and psychological status are related in a vicious circle. The aim of this study was to determine the relationships between improvement in parameters of PAD after endovascular procedures and changes in patients' physical and psychological status. METHODS: We studied 140 consecutive patients with PAD: 50 patients with chronic limb-threatening ischemia (CLTI), 50 patients with intermittent claudication (IC) undergoing an endovascular procedure, and 40 patients with IC who were not qualified for leg revascularization. All participating patients were assessed at the beginning of the study and at 3 and 12 months of follow-up; scores taken included ankle-brachial index, 6-minute walking test distance, Barthel Index, activities of daily living index, instrumental activities of daily living (IADL) index, Mini-Mental State Examination, and Hospital Anxiety and Depression Scale. RESULTS: After 12 months of follow-up, an improvement in PAD-related symptoms following leg revascularization had been maintained in 56% of the patients with CLTI and in 68% of those with IC. Twelve months after endovascular leg revascularization, the scores in respect of activities of daily living, IADL, and Mini-Mental State Examination had increased, and scores for Hospital Anxiety and Depression Scale had decreased in patients with both CLTI and IC. A higher baseline score in the IADL index was associated with a reduction in the 1-year cardiovascular event risk (odds ratio, 95% confidence interval, 0.70; 0.54-0.91; P < .01). CONCLUSIONS: In patients with PAD, endovascular procedures not only improved PAD-related symptoms, but also ameliorated patients' physical state, improved cognitive function, and reduced depression.