Please select the eligibility criteria that correspond to the clinical trial below.
Title: Randomised Controlled Trial of Percutaneous Transluminal Angioplasty (PTA) Versus a Supervised Exercise Programme (SEP) in the Management of Intermittent Claudication (IC) Due to Femoro-popliteal Disease
Brief Summary: Intermittent Claudication (IC)is a common condition characterised by pain in the muscles of the legs on exertion caused by "hardening of the arteries" and a reduced blood supply. The investigators know that the vast majority of people suffering from this condition remain stable and do not deteriorate, and thus in general the viability of legs is not at risk. The main aim of treatment, therefore, is to try and improve walking thus reducing the impact this problem has on patients life style. There are many methods of management of intermittent claudication, but the investigators do not know which produces the best results. This study aims to compare the short and medium term outcomes of exercise programmes, percutaneous transluminal angioplasty and a combination of the two treatments for patients with intermittent claudication.


Options:
A: Inclusion Criteria:

* PAD stage 2 or 3 according to Fontaine,
* Surgical or radiological intervention indicated

Exclusion Criteria:

* No insurance for physiotherapy,
* Insufficient command of the Dutch language,
* Serious cardiopulmonary limitations (NYHA 3-4,)
* Major amputation,
* Serious co-morbidity prohibiting physical training
B: Inclusion Criteria:

1. Age 18 years or older;
2. Disabling claudication as defined by surgeon based on patient's history;
3. Ankle/Brachial Index (ABI) \< 0.9 or drop in ABI \> 0.15 after exercise test;
4. Hemodynamic stenosis of the common or external iliac artery on Color Duplex Scanning (CDS) (PSV ratio ≥ 2.5 or EDV ≥ 0.6 m/s) or on Magnetic Resonance Angiography (MRA) or Computed Tomography Angiography (CTA)(\> 50% stenosis) or occlusion of the common or external iliac artery on CDS (PSV 0 m/s) or on MRA or CTA;
5. Iliac artery lesion and a concomitant stenosis in the superficial femoral artery defined as stenosis \> 50% by CDS (PSV ratio ≥ 2.5 or EDV ≥ 0.6 m/s) or on MRA or CTA, or occlusion on CDS (PSV 0 m/s) or MRA or CTA;
6. Lesion classified A, B or C according to the TASC (TransAtlantic Inter-Society Consensus) classification of aortoiliac lesions;
7. Patient is able to walk at least 2 minutes on a treadmill at 3.2 km/h and 10% incline;
8. The Maximum Walking Distance on a treadmill \< 300 meters.

Exclusion Criteria:

1. Life expectancy \< 3 months;
2. Patient is unable to complete self-reported questionnaires (insufficiently reading or speaking the Dutch language, cognitive disorders, etc);
3. Patient is unable to give informed consent;
4. A documented contrast allergy;
5. Pregnancy;
6. Contra-indication for anticoagulant therapy;
7. Duration of current complaints \< 3 months;
8. Occlusion of the common femoral artery at the affected side;
9. Patient participates in another study;
10. Heart failure or Angina Pectoris NYHA III or IV. (NYHA III: Marked limitation of physical activity. Comfortable at rest, but less than ordinary activity causes fatigue, palpitation, or dyspnea; NYHA IV: Unable to carry out any physical activity without discomfort. Symptoms of cardiac insufficiency at rest. If any physical activity is undertaken, discomfort is increased);
11. Patient previously received Supervised Exercise Therapy (SET) according to KNGF (Dutch Society for Physiotherapists) guidelines;
12. Renal insufficiency (serum creatinin \> 150 micromol/l).
C: Inclusion Criteria:

* Symptomatic unilateral Intermittent Claudication Femoro-popliteal lesion Angioplastiable lesion on duplex \> 3 months on BMT

Exclusion Criteria:

* Critical ischaemia Incapacitating systemic disease Inability to tolerate treadmill testing Ischaemic changes on ECG during treadmill testing Ipsilateral surgery / PTA in previous 6 months
D: Inclusion Criteria:

* Patient with intermittent claudication (typical symptoms and ABI \<0.9) seeking treatment
* Significant aortoiliac- and/or femoropopliteal lesion.
* Age 30-80 years

Exclusion Criteria:

* Invasive treatment contraindicated because of severe intercurrent disease.
* Two or more failed vascular reconstructions in the same leg.
* Employees unable to work because of intermittent claudication.
* Need for open reconstruction below the tibioperoneal trunc.
* Thromboembolic etiology (popliteal artery aneurysm; cardiac emboli)
* Other disease severely affecting walking performance.
* Body weight \> 120 kilograms.
* Age \<30 or \> 80 years.

Answer: C