7
Table 5. Exercise Therapy
Recommendations Grade
Level of
Evidence
The SVS recommends as first-line therapy a supervised
exercise program consisting of walking a minimum of three
times per week (30–60 min/session) for ≥12 weeks for all
suitable patients with IC.
1 A
The SVS recommends home-based exercise, with a goal of
≥30 minutes of walking three to five times per week when a
supervised exercise program is unavailable or for long-term
benefit after a supervised exercise program is completed.
1 B
In patients who have undergone revascularization therapy
for IC, the SVS recommends exercise (either supervised or
home-based) for adjunctive functional benefits.
1 B
The SVS recommends that patients with IC be followed
up annually to assess compliance with lifestyle measures
(smoking cessation, exercise) and medical therapies as well as
to determine if there is evidence of progression in symptoms
or signs of PAD. Yearly ABI testing may be of value to
provide objective evidence of disease progression.
1 C
The SVS suggests against using folic acid and vitamin B
12
supplements as a treatment of IC.
2 C
In patients with IC who do not have congestive heart failure,
the SVS suggests a 3-month trial of cilostazol (100 mg twice
daily) to improve pain-free walking.
2 A
In patients with IC who cannot tolerate or have
contraindications for cilostazol, the SVS suggests a trial of
pentoxifylline (400 mg thrice daily) to improve
pain-free walking.
2 B
A recommendation for using ramipril in IC was originally made but subsequently
deleted (see Supplementary Material on page 41S.e1, online only).
Table 4. Medical Treatment for Intermittent Claudication
(cont'd)
Recommendations Grade
Level of
Evidence
