Exercise therapy results of postoperativ treated critical iliac artery stenosis (TASC II A and B) patients who were infected with the Covid 19

Main Article Content

Sid Solakovic Haris Serhatlic Nina Solakovic Fedja Hajrulahovic Ratko Pavlović Mensur Vrcic Zhanneta Kozina Dan Iulian Alexe Ksennia Yarimbash Olena Dorofieieva


Introduction: Adequate individual physical activity after COVID 19 infection as a inevitable part of postoperative therapy of surgically treated vascular and endovascular patients witch still remains a scientific unexplored international neglected secret. General post-covid symptomatology is increasingly present in patients with surgical or endovascular procedures on the iliac segment in the form of a manifestation of various complaints that can affect the very accessibility of the choice of treatment according to the TASC II guidelines, but also affect physical activity and quality of life. Besides the medicament treatment, the management of moderate intensity exercise therapy and future consistency of self-controlled exercise after surgical and endovascular after treatment in iliac critic stenosis with other asymptomatic systemic atherosclerosis can be important factor to support and improve benefits of surgical and endovascular treatment outcome in variable symptomatology of POSTCOVID 19 patients treated classical surgical and endovascular.

Goals: The focus is on priority of investigation of remodeling   the pattern of cultural smoking behavior and increasing the dynamic of physical activity trying to prevent and avoid potential risk of sudden death, myocardial infarction, stroke graft (stent) occlusion, and cardiovascular mortality in patients with POSTCOVID 19 symptomatology in which is besides other asymptomatic systemic atherosclerosis is the main disease critical iliac artery stenosis (TASC II A and B). Scientifically unproven that sometimes can be associated with poor outcome of surgical intervention the which are in deficit with scientific studies to confirm these scientific observations. Second goals are to investigate the potential possibility of POST COVID 19 symptomatology associated with the success of classic surgical bypass or endovascular intervention and the possibility of reflection on physical activity after vascular intervention. Also the improving and secure the quality of life after successful surgical bypass and endovascular revascularization treatment with influence on primary iliac (TASC II A and B) vascular intervention potency one of main goals as well suppress permanent or permanent consequences of the Covid 19 virus during therapeutic surgical or endovascular procedures of the iliac segment (TASC II A and B) Traditional food as well wrong choice of diet and continuous fight with nicotinism is still remains generally main health threat.

Subjects and Methods: 266 Symptomatic post COVID 19  Patients with were observed during 3 years (134 patients with surgical dacron reconstruction and 132 with endovascular treatmant of short segment critical iliac artery stenosis) Moderate interval Intensity Training with Short Interval Repetitions on standard treadmill procedure.

Results: The connection of the outcome of surgical and endovascular treatment with post and long covid 19 symptomatology is possible and has a significant impact on the quality of the continuation of physical medication therapy. Difference between the surgical and endovascular groups was observed after the implementation of the treatment as well as factors affecting the outcome of therapy. the outcome is devastating with the prevention of the risk factor of nicotism as well as with the lack of physical activity in some groups.

Conclusion: Primary potency after Three years of Endovascular procedure and Dacron bypass Revascularization, has shown as successful with support of supervised exercise training in POSTCOVID 19 patients. Nicotiism still remains highly potency outcome threat when supporting exercise therapy. Also, future and recent studies on this topic should expand their understanding of the effect of the COVID 19 virus on the body in this patients, as well as improving the quality of life in order to improve the patency of bypass or endovascular intervention on the arterial iliac segment.

Keywords: Surgical Treatment, Endovascular treatment, Symptomatic Post-Covid 19 and long COVID 19 Patients, Moderate Intensity Exercise Therapy, Critical Iliac Artery (TASC II A and B)

Article Details

How to Cite
SOLAKOVIC, Sid et al. Exercise therapy results of postoperativ treated critical iliac artery stenosis (TASC II A and B) patients who were infected with the Covid 19. Medical Research Archives, [S.l.], v. 12, n. 5, may 2024. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/5298>. Date accessed: 19 june 2024. doi: https://doi.org/10.18103/mra.v12i5.5298.
Research Articles


1. Park AH, Zhong S, Yang H, Jeong J, Lee C. Impact of COVID-19 on physical activity: A rapid review. J Glob Health. 2022; 12:05003. doi: 10.7189/jogh.12.05003.

2. Beltrame A, Salguero P, Rossi E, ... et Valsecchi MG. Association Between Sex Hormone Levels and Clinical Outcomes in Patients With COVID-19 Admitted to Hospital: An Observational, Retrospective, Cohort Study. Front Immunol. 2022; 13: 834851. doi: 10.3389/fimmu.2022.834851.

3. Rabani S, Sardarinia M, Akbarpour S, Azizi F, Khalili D, Hadaegh F.12-year trends in cardiovascular risk factors (2002-2005 through 2011-2014) in patients with cardiovascular diseases: Tehran lipid and glucose study. PLoS One. 2018; 13(5):e0195543. doi: 10.1371/journal.pone.0195543.

4. Çuhadar S, Atay A, Sağlam G, Köseoğlu M, Cuhadar L.Cardiovascular risk factors in young male adults: impact of physical activity and parental education. Cent. Asian J Glob Health. 2013; 2(1): 44. doi: 10.5195/cajgh.201 3.44. eCollection 2013.

5. Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG; TASC II Working Group Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). J Vasc Surg. 2007; 45 (suppl S):S5-67.

6. Murphy TP, Webb MS, Lambiase RE, Haas RA, Dorfman GS, Carney WI, et al. Percutaneous revascularization of complex iliac artery stenoses and occlusions with use of Wallstent: three-year experience. J Vasc Interv Radiol. 1996; 7:21-27.

7. Ozkan U, Oguzkurt L, Tercan F. Technique, complication, and longterm outcome for endovascular treatment of iliac artery occlusion. Cardiovasc Intervent Radiol. 2010;33:18-24.

8. Timaran CH, Stevens SL, Freeman MB, Goldman MH. External iliac and common iliac artery angioplasty and stenting in men and women. J Vasc Surg. 2001; 34:440-6.

9. Timaran CH, Prault TL, Stevens SL, Freeman MB, Goldman MH. Iliac artery stenting versus surgical reconstruction for TASC (TransAtlantic Inter Society Consensus) type B and type C iliac lesions. J Vasc Surg. 2003; 38: 272-278.

10. Norgren L, Hiatt WR, Dormandy JA, et al. TASC II,Working Group. Inter-society Consensus for theManagement of Peripheral Arterial Disease (TASC II). Eur J Vasc Endovasc Surg., 2007; 33 Suppl 1:S1–75.

11. Adili F, Balzer K, Betz T, Billing A, Böckler D, ... et al. Zimmermann A. Current practice of first-line treatment strategies in patients with critical limb ischemia. J Vasc Surg. 2015; 62: 965-973.

12. Chang P, Nead KT, Olin JW, Myers J, Cooke JP, Leeper NJ. Effect of physical activity assessment on prognostication for peripheral artery disease and mortality. Mayo Clin Proc. 2015;90:339–45.

13. Sakamoto S, Yokoyama N, Tamori Y, Akutsu K, Hashimoto H, Takeshita S. Patients with peripheral artery disease who complete 12-week supervised exercise training program show reduce cardiovascular mortality and morbidity. Circ J. 2009;73: 167–73.

14. Gardner AW, Montgomery PS, Parker DE. Optimal exercise program length for patients with claudication. J Vasc Surg. 2012; 55:1346–54.

15. Popplewell MA, Bradbury AW. Why do health systems not fund supervised exercise programmes for intermittent claudication? Eur J Vasc Endovasc Surg. 2014; 48:608–10.

16. Collins TC, Lunos S, Carlson T, et al. Effects of a home-based walking intervention on mobility and quality of life in people with diabetes and peripheral arterial disease: a randomized control trial. Diabetes Care. 2011;34:2174–9.

17. Casillas JM, Gremeaux V, Damak S, Feki A, Pérennou D. Exercise training for patients with cardiovascular disease. Ann Readapt Med Phys. 2007; 50(6):403-18, 386-402. English, French. doi: 10.1016/j.annrmp.2007.03.007

18. Łudzik D, Nessler J. Role of physical training in cardiac rehabilitation in patients with congestive heart failure]. Przegl Lek. 2004;61(2):105-8. Polish. PMID: 15230152.

19. McConnell TR, Mandak JS, Sykes JS, Fesniak H, Dasgupta H Exercise training for heart failure patients improves respiratory muscle endurance, exercise tolerance, breathlessness, and quality of life. J Cardiopulm Rehabil. 2003; 23(1):10-6.

20. Støa EM, Meling S, Nyhus LK, et al. High-intensity aerobic interval training improves aerobic fitness and HbA1c among persons diagnosed with type 2 diabetes. Eur J Appl Physiol., (2017); 117: 455.

21. Gaeini AA, Satarifard S, Heidary A et al. Comparing the effect of eight weeks of high-intensity interval training and moderate-intensity continuous training on physiological variables of exercise stress test in cardiac patient after coronary artery bypass graf. Journal of Isfahan Medical School. 2014; 31(267): 2171-2181.

22. Kelley GA, Kelley KS, Franklin B,e t al. Aerobic exercise and lipids and lipoproteins in patients with cardiovascular disease: a meta-analysis of randomized controlled trials. J Cardiopulm Rehabil. 2006; 26(3):131-9.

23. Tanasescu M, Leitzmann MF, Rimm EB, et al. Exercise Type and Intensity in Relation to Coronary Heart Disease in Men. JAMA. 2002;288(16):1994-2000.

24. Cachovan M et al. Methods and results of controlled walking training in patients with peripheral arterial occlusive disease. Z Arztl Fortbild Qualitatssich.1999; 93(9):626-32.

25. Spronk S, Bosch JL, den Hoed PT, et al. Cost-effectiveness of endovascular revascularization compared to supervised hospital-based exercise training in patients with intermittent claudication: a randomized controlled trial. J Vasc Surg. 2008;48(6):1472–80.

26. Chetter IC, Dolan P, Spark JI, et al. Correlating clinical indicators of lower-limb ischaemia with quality of life. Cardiovasc surg. 1997; 5(4),361–6.

27. Dumville JC, Lee AJ, Smith FB, et al. The health related quality of life of people with peripheral arterial disease in the community: the Edinburgh Artery Study. Br J Gen Pract. 2004;54(508): 826–31.

28. McDermott MM, Greenland P, Liu K, et al. Leg symptoms in peripheral arterial disease: associated clinical characteristics and functional impairment. JAMA. 2001;286(13):1 599–606.

29. Porter JM. Endovascular arterial intervention: expression of concern. Journal of Vascular Surgery. 1995, 21, 995–997.

30. Fraser S.C.A. Quality of life measurement in surgical practice. British Journal of Surgery. 1993 (80): 163–169.

31. Norgren L, Hiatt WR, Dormandy JA, et al. TASC II Working Group.Inter-society consensus for the management of peripheral arterial disease (TASC II). J Vasc Surg., 2007; 45 Suppl S:S5–67.

32. Parmenter BJ, Raymond J, Dinnen, et al. A systematic review of randomized controlled trials: walking versus alternative exercise prescription as treatment for intermittent claudication. Atherosclerosis. 2011; 218(1):1–12.

33. Lane R, Watson L, Leng GC. Exercise for intermittent claudication. Cochrane Database Syst Rev. 2014; 18; (7).

34. Stewart AH, Lamont PM. Exercise for intermittent claudication.Supervised programmes should be universally available. BMJ. 2001; 29; 323(7315):703–4.

35. Bendermacher BL, Willigendael EM, Nicolaï SP, et al. Supervised exercise therapy for intermittent claudication in a community-based setting is as effective as clinic-based. J Vasc Surg., 2007; 45:1192–6.

36. Müller-Bühl U, Engeser P, Leutgeb R, et al. Low attendance of patients with intermittent claudication in a German community-based walking exercise program. Int Angiol. 2012;31:271–5.

37. Gardner A. Exercise rehabilitation for peripheral artery disease An exercise physiology perspective with special emphasis on the emerging trend of home-based exercise Vasa 2015;44:405–17.

38. Rabijewski M, Papierska L, Kuczerowski R, Piątkiewicz P. Hormonal determinants of the severity of andropausal and depressive symptoms in middle-aged and elderly men with prediabetes. Clin Interv Aging. 2015;10:1 381-91.

39. Amore M. Partial androgen deficiency and neuropsychiatric symptoms in aging men. J Endocrinol Invest. 2005; 28(11 Suppl Proceedings): 49-54. PMID: 16760626.

40. Seidman SN. Testosterone deficiency and mood in aging men: pathogenic and therapeutic interactions. World J Biol Psychiatry. 2003; 4(1):14-20. doi: 10.3109/156 22970309167905.

41. Seidman SN. Androgens and the aging male. Psychopharmacol Bull. 2007; 40(4):205-18. PMID: 18227789.

42. Solakovic S, Vrcic M, Pavlovic R et al. Whether exercises and testosterone replacement therapy support a treatment for cardiovascular and atherosclerotic patients with iliac artery stenosis and low total testosterone and high-density lipoprotein cholesterol after endovascular procedure? Zaporozhye medical journal. 2023; 25 (2):101-108.

43. Solaković S, Spahović H, Pavlović R, Jogunčić A, Solaković N, Vrcić M, Hajrulahović F. Connection of Low Serum Testosterone Levels in Cardiovascular Disease in Metabolic Syndrome Patients with Diagnosis of Critic Iliac Artery Stenosis (TASC II A and B) and Can Exercise Improve those Levels and Primary Potency of Revascularization after Surgical and Endovascular Treatment? (Pilot Study). Saudi J Med. 2023; 8(1): 8-17.

44. Solakovic S, Vrcic M, Pavlovic R, et al. Effects of moderate-intensity continuous training therapy on claudication symptoms and carotid intima-media thickness in patients after endovascular and classical bypass treatment (a pilot study). Zaporozhye medical journal. 2020; 22 (6): 775-78

45. Solakovic S, Vrcic M, Pavlovic R et al. Vascular Rehabilitation Benefits of Tribulus Terrestris (TT), Taurine and High Dose Alpha Lipoic Acid (ALA) Supplementation with Interval Walking Training Program after Surgical Vascular Bypass Treatment (Pilot Study). International Journal of Kinesiology and Sports Science. 2019; 7 (3):22-33.

46. Solakovic S, Vrcic M, Pavlovic R et al. Can Self-controlled Stationary Bicycle Moderate Intensity Training Increase Claudication Distance in Patients with Fontains Stage IIa without the Effects of Expansion on Infrarenal Abdominal Aortic Aneurysm (IAAA) Diametar without Iliac Artery Dilatation (IAD) and Iliac Artery Aneurysms (IAA)? International journal of Exercise Physiology. 2019; 8 (3.1): 180-190

47. Solakovic S, et al. Can the Irregular Acetylsalicylic acid (ASA) Therapy combined with Interval Training Exercise Program Increase the Claudication Distance in Diabetic and Non-diabetic Patients with Femoro-popliteal Stenosis Age over 55. European Journal of Physical Education and Sport Science. 2017; 3(2):19-32. doi: 10.5281/zenodo.375659.

48. Solakovic S, Vrcic M, Pavlovic R et al. Irational Abuse of Anabolic Steroids Stacking with Aromatase Inhibitors Increase Carotid Intima-Media Thickness (CIMT) and Lowerining High Density Lipoprotein (HDL) levels Causing High Risk Factors for Cardiovascular Disease and Potential Steatohepatitis in Young Recreational Bodybuilders Age 17-30 (pilot study). International journal of Exercise Physiology. 2019;8 (3.1): 197-207.

49. Solakovic S, Vrcic M, Pavlovic R, et al. Irrational Abuse of Testosterone and Mass Supplements by Recreational Bodybuilders with “Adonis Complex” Leads to Potential Cardiovascular Diseases and Psychophysical Disorders. International Journal of Sports Science. 2016; 6(6): 230-236

50. Solakovic S, Vrcic M, Pavlovic R, et al. HDL Level In Amateur Bodybuildres Who Misuse The Combination Of Testesterone Products And Anabolic Steroids In Bosnia And Herzegovina. Slovak Journal of Sport Science. 2016; 1 (1): 2-8

51. Solakovic S, Vrcic M, Pavlovic R, et al. Potential Cardiovascular Side Effects Of Trenbolone Acetate Steroid Stacking In Young Section A-Research paper Recreational Bodybuilders Compared With Another Potential Cardiovascular Side Effects Of Anabolic Steroids And What Is Thoroughly Hiding Behind Trenbolone Acetate Roid Rage Myth? European Chemical Bulletin.2022; 11(11):64-72.

52. Solakovic S, et al.: Hidden Danger of Irrational Abusing Illegal Androgenic-anabolic Steroids. Med Arh. 2015; 69 (3): 200-202.

53. Solaković S, Vrcić M, Pavlović R. Does Obsession Of Irrational Stacking Anabolic Steroids With Trenbolone Acetate Over Decades Leads To General, Cardiovascular Or Social Deviation Problem In Young Adults, Or Just Biggest Muscle Mass Is Equal Highest Social Reputation In Gym And Is This All Price Health Worth? - Case Report. European Journal Of Physical Education And Sport Science 2019; (5):7 54-63

54. Emery S, Gilpin EA, Ake C, Farkas AJ, Pierce JP. Characterizing and identifying "hard-core" smokers: implications for further reducing smoking prevalence. Am J Public Health. 2000; (90):387-394.

55. Prochaska JO, DiClemente CC. Stages of change in the modification of problem behaviors. Prog Behav Modif. 1992; (28):183-218.

56. Nduaguba SO, Ford KH, Rascati K. The Role of Physical Activity in the Association Between Smoking Status and Quality of Life. Nicotine Tob Res. 2019; 21(8):1065-1071. doi: 10.1093/ntr/nty052.

57. Kirsten T et al. Leisure time physical activity motives and smoking in adolescence. Psychology of Sport and Exercise.2009; 10 (5):559-564.

58. Crespo CJ et al. Lesure –time physical activity among Us adults. Arch Intern Med.1996;156:93-98

59. Gary O Donovan et al. The associacion between lesure –time physical asctivity and low Hdl –cholesterol and mortallitty in a poold analysis of nine population-based chorts. Eu J Epidemiol. 2017; (32):559-556.

60. Igarashi Y, Nogami Y.Response of Lipids and Lipoproteins to Regular Aquatic Endurance Exercise: A Meta-Analysis of Randomized Controlled Trials. J Atheroscler Thromb. 2018 May 8. doi: 10.5551/jat.42937.

61. Despres JP. & Lamarche B. Low-intensity endurance exercise training, plasma lipoproteins and the risk of coronary heart disease. Journal of Internal Medicine.1994; 236 (1): 7–22.

62. Doolan DM, Froelicher ES. Smoking cessation interventions and older adults. Prog Cardiovasc Nurs. 2008; 23:119–127

63. Abdullah ASM, Simon JL. Health promotion in older adults: evidence-based smoking cessation programs for use in primary care settings. Geriatrics. 2006: 61:30–34

64. Zbikowski SM, Magnusson B, Pockey JR, Tindle HA, Weaver KE. A review of smoking cessation interventions for smokers aged 50 and older. Maturitas. 2012; 71:131–141

65. Kim J, Tanabe K, Yokoyama N, Zempo H, & Kuno S, Objectively measured light-intensity lifestyle activity and sedentary time are independently associated with metabolic syndrome: a cross-sectional study of Japanese adults. International Journal of Behavioral Nutrition and Physical Activity. 2013; (10): 30.

Most read articles by the same author(s)