17
Table 19. Recommendation for Chelation Therapy
COR LOE
Recommendation
III: No
Benefit
B-R Chelation therapy (e.g., ethylenediaminetetraacetic acid) is NOT
beneficial for treatment of claudication.
Table 20. Recommendation for Homocysteine Lowering
COR LOE
Recommendation
III: No
Benefit
B-R B-complex vitamin supplementation to lower homocysteine
levels for prevention of cardiovascular events in patients with
PAD is NOT recommended.
Table 21. Recommendation for Influenza Vaccination
COR LOE
Recommendation
I C-EO Patients with PAD should have an annual influenza vaccination.
Table 22. Structured Exercise Therapy
COR LOE
Recommendations
I A In patients with claudication, a supervised exercise program is
recommended to improve functional status and QoL and to
reduce leg symptoms.
I B-R A supervised exercise program should be discussed as a treatment
option for claudication before possible revascularization.
IIa A In patients with PAD, a structured community- or home-based
exercise program with behavioral change techniques can be
beneficial to improve walking ability and functional status.
IIa A In patients with claudication, alternative strategies of exercise
therapy, including upper-body ergometry, cycling, and pain-free
or low-intensity walking that avoids moderate-to-maximum
claudication while walking, can be beneficial to improve walking
ability and functional status.
