Abstract
Introduction. This study aimed to determine the effect of revascularisation on walking tolerance, calf muscle function and leg blood flow in PAD. Methods: 12 men and 3 women (age 63 +/- 8 y) with PAD scheduled to undergo revascularisation were included. Resting ABI of the limb to be revascularised (VASC) was 0.72 +/- 0.11 compared to 0.95 +/- 0.19 for the non revascularised limb (NON-VASC).Assessments before and 2-4 weeks after revascularisation included 6MWD, calf muscle strength, endurance, fatigueand leg blood flow during calf exercise using strain gauge plethysmography. Results. ABI increased in VASC limbs following revascularisation (pre 0.72; post 1.05) and there was a non-significant increase in 6MWD (pre 352; post 408 m, p = 0.07). Exercise blood flow magnitude increased (pre 26.2; post 38.1 ml.100ml-1.min-1) in the VASC limbs with increased amplitude for both the early and late phases of the exercise blood flow response. The time delay preceding thelate blood flow phase decreased in the VASC (pre 22.4; post 15.4s) compared with the NON-VASC limbs (pre 14.4; post 17.4s). Muscle endurance, but not strength, was increased in VASC (pre 259; post 525s) but not the NON-VASC limbs (pre 516; post 586 s). There were no significant changes in muscle fatigue, although there tended to be an increase in the timedelay prior to the late fatigue phase for the revascularised limbs (VASC: pre 152; post 202. NON-VASC: pre 221; post 207s, p = 0.09). Discussion. Revascularisation lead toa faster kinetic response of blood flow and an increased blood flow magnitude during plantar flexion exercise. These changes were associated with positive changes in walking capacity and calf muscle function.