Please select the eligibility criteria that correspond to the clinical trial below.
Title: SUPERvised Exercise Therapy (SET) or Immediate Percutaneous Transluminal Angioplasty (PTA) for Intermittent Claudication (IC) in Patients With an Iliac Artery Obstruction: A Randomized Controlled Trial. SUPER Study
Brief Summary: The purpose of our study is to compare the clinical effectiveness and cost-effectiveness of two treatment strategies of Intermittent Claudication (IC) due to an iliac artery obstruction: to start with SUPERvised Exercise Therapy (SET) and deferred Percutaneous Transluminal Angioplasty (PTA) in case of SET failure, or immediate PTA.

It is our hypothesis that PTA as first line treatment is more effective than SET as first line treatment with regard to maximum walking distance, quality of life and costs after one year.


Options:
A: Inclusion Criteria:

* Peripheral artery disease with intermittent claudication (Rutherford 2-3)
* Exercise tolerance
* Ankle brachial index \< 0,9
* Ability to life independently at home

Exclusion Criteria:

* No PAD
* Asymptomatic PAD
* Ischemic rest pain
* Exercise tolerance limited by other factors than claudication (e.g., coronary artery disease, dyspnoea, poorly controlled blood pressure, any kind of restriction of the musculoskeletal system which might have an influence on the efficiency of exercise training)
B: Inclusion Criteria:

* PAD stage II
* Ankle-brachial index below 0.9
* Maximal walking distance of 500 meters or less

Exclusion Criteria:

* prior ET
* previous peripheral vascular interventions
* no insurance for physiotherapy
* insufficient command of the Dutch language
* serious cardiopulmonary limitations (NYHA-3-4)
* previous amputation
* psychiatric instability
* other serious co-morbidity prohibiting physical training
C: 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
D: 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).

Answer: D