Conventional wisdom might suppose that everyone would avoid surgery if possible.
But a research team in Houston has found that some patients who could choose between exercise or a surgical procedure to improve their leg pain were more likely to choose surgery.
Vascular surgeon and principal investigator Neal Barshes, MD, and researcher Sherene E. Sharath, MPH, surveyed 102 military veterans. The patients were mostly male, 65 or older, and suffering from leg pain due to peripheral arterial disease (PAD), which is caused by plaque buildup in the leg arteries due to hardening of the arteries.
Patients who preferred a stent solution over exercise were likely to know someone else who had gotten a stent, have a lower socioeconomic status, or smoke cigarettes.
“We don’t know exactly why there is a correlation with smoking,” said Barshes. “I suspect that people who currently smoke are less likely to initiate their own changes in health behaviors.”
“We thought that economic disadvantage might just be a proxy for lack of adequate exercise facilities or sidewalks,” Sharath said. “Previously, we found associations between difficulty walking in neighborhoods due to traffic and safety issues, lack of sidewalks, and the severity of pain. This environmental disadvantage may encourage people to seek the ‘quick-fix’ of stenting rather than the relatively slower results that can be expected from exercise.”
Additionally, patients who knew someone who had the procedure done were more likely to believe that surgery was best, the researchers found, despite a surgeon’s advice that exercise worked just as well.
The lack of interest in going for regular walks was interesting, Barshes said, given that all the participants were former military. “At one point in their life they were pretty physically fit due to military service,” he said.
This article was adapted from information provided by the Society for Vascular Surgery.
