1239 - Prehabilitation Prior to Endovascular Lower-Extremity Revascularization: Impact on Outcomes in Peripheral Artery Disease

Friday, February 20, 2026

5:00 PM - 6:30 PM AST

Co-Author(s)

DD

Danree Delancy, n/a

Medical Student
Howard University College of Medicine
Washington, District of Columbia, United States
EM

Elliana Mills, n/a

Medical Student
Howard University College of Medicine
Washington, District of Columbia, United States
EB

Elizabeth Beyene, n/a

Medical Student
Howard University College of Medicine
Washington, District of Columbia, United States
SG

Syed Fahad Gillani, n/a

Student
HUCM
Washington, District of Columbia, United States
RE

Rawan Elkomi, MD

Researcher
Howard University College of Medicine
Washington, District of Columbia, United States

Presenting Author(s)

SE

Somtochi A. Edeh, n/a

Medical Student
Howard University College of Medicine
SOUTH HOLLAND, Illinois, United States
QJ

Quinton Johnson, n/a

Medical Student
Howard University College of Medicine
Washington, District of Columbia, United States

Corresponding Author(s)

MM

Miriam Michael, MD

Project Overseer
HUCM
Washington, District of Columbia, United States

Submitter(s)

SE

Somtochi A. Edeh, BS

Howard University College of Medicine
SOUTH HOLLAND, Illinois, United States

Objectives: To evaluate whether pre-admission physical therapy (prehabilitation) is associated with improved outcomes, including reintervention, amputation, and recurrence following endovascular lower-extremity revascularization in patients with peripheral artery disease.

Design:

A retrospective cohort study was performed using the TriNetX federated health research network. Adults with peripheral artery disease undergoing endovascular revascularization were identified and stratified into two groups: those receiving prehabilitation (n=35,477) and those without (n=97,902). Propensity score matching created balanced cohorts of 35,446 patients each. Outcomes including repeat revascularization, amputation, and recurrence were assessed over one year using risk analysis, Kaplan–Meier survival, and hazard ratios.

Results:

Prior to matching, prehabilitation patients had greater comorbidity burden and medication use. After matching, baseline demographics and comorbidities were well balanced. Compared to non-prehabilitation, prehabilitation significantly reduced reintervention (15.1% vs 20.9%; HR 1.43, p< 0.001), amputation (3.7% vs 4.2%; HR 1.14, p=0.001), and recurrence (77.4% vs 80.7%; HR 1.17, p< 0.001). Kaplan–Meier analyses demonstrated superior one-year event-free survival across all outcomes in the prehabilitation cohort.

Conclusions:

Pre-admission physical therapy is associated with meaningful improvements in outcomes following endovascular revascularization for peripheral artery disease. Despite a higher comorbidity burden, patients receiving prehabilitation had reduced risks of reintervention, limb loss, and disease progression. These findings highlight prehabilitation as a promising adjunct to optimize perioperative care, improve durability of revascularization, and enhance long-term limb preservation. Prospective studies are warranted to confirm causality and guide clinical implementation.