462-61 |Is There a Role for the Vascular Lab in Supporting Home-Based Vascular Rehabilitation Programs? A Case Series-Is There a Role for the Vascular Lab in Supporting Home-Based Vascular Rehabilitation Programs? A Case Series

Is There a Role for the Vascular Lab in Supporting Home-Based Vascular Rehabilitation Programs? A Case Series

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This article discusses the role of the vascular laboratory in supporting home-based vascular rehabilitation programs for patients with intermittent claudication caused by peripheral arterial disease (PAD). Intermittent claudication is characterized by pain and fatigue in the calves during exercise and is a marker of vascular disease. The article highlights the limitations of using the ankle/brachial index (ABI), a standard diagnostic tool, in evaluating lower limb perfusion, particularly in patients with noncompressible tibial arteries. The article introduces pedal acceleration time (PAT), a novel technique that quantifies perfusion using duplex ultrasound and overcomes the limitations of the ABI. PAT is classified into four categories based on the severity of ischemia. The article describes a pilot study that assessed the efficacy of a nonsupervised exercise program for intermittent claudication and presents case descriptions of four patients. The patients were instructed to walk until symptoms developed and then rest and recover before continuing to walk. Smoking cessation and medication (such as cilostazol) were also encouraged. The patients' symptoms, smoking status, and perfusion markers were monitored. Among the four patients described, three experienced symptomatic improvement and improvement in PAT classification. The article concludes that nonsupervised exercise alone may not be sufficient management for claudication in PAD, but PAT may offer a better approach to monitoring disease progression and guiding management. The vascular laboratory can play a significant role in supporting and encouraging patients in their home-based exercise programs.

Keywords

vascular laboratory

home-based vascular rehabilitation

intermittent claudication

peripheral arterial disease

PAD

ankle/brachial index

lower limb perfusion

pedal acceleration time

nonsupervised exercise program

disease progression