• Cochrane Db Syst Rev · Jan 2000

    Review

    Angioplasty (versus non surgical management) for intermittent claudication.

    • F G Fowkes and I N Gillespie.
    • Wolfson Unit for the Prevention of Peripheral Vascular Diseases, Public Health Sciences, University of Edinburgh, Medical School, Teviot Place, Edinburgh, UK, EH8 9AG. gerry.fowkes@ed.ac.uk
    • Cochrane Db Syst Rev. 2000 Jan 1 (2): CD000017CD000017.

    BackgroundIntermittent claudication is pain in the legs due to muscle ischaemia associated with arterial stenosis or occlusion. Angioplasty is a technique that involves dilatation and recanalisation of a stenosed or occluded artery.ObjectivesThe objective of this review was to determine the effects of angioplasty of arteries in the leg when compared with non surgical therapy, or no therapy, for patients with mild to moderate intermittent claudication.Search StrategyThe reviewers searched the Cochrane Peripheral Vascular Diseases Group trials register and reference lists of relevant articles. The reviewers also contacted investigators in the field and hand searched recent conference proceedings.Selection CriteriaRandomised trials of angioplasty for mild or moderate intermittent claudication.Data Collection And AnalysisOne reviewer extracted data and both reviewers assessed trial quality independently.Main ResultsTwo trials with a total of 98 participants were included. The average age was 62 years old with 20 women and 789 men. Patients were followed for 15 months in one trial and six years in another. At six months of follow up, mean ankle brachial pressure indices were higher in the angioplasty groups than control groups (weighted mean difference 0.17, 95% confidence interval 0.11 to 0.24). In one trial, walking distances were greater in the angioplasty group, but in the other trial, in which controls underwent an exercise programme, walking distances did not show a greater improvement in the angioplasty group. At two years of follow up in one trial, the angioplasty group were more likely to have a patent artery (odds ratio 5.5, 95% confidence interval 1.8 to 17.0) but not a significantly better walking distance or quality of life. In the other trial, long term follow up at six years demonstrated no significant differences in outcome between the angioplasty and control groups.Reviewer's ConclusionsThese limited results suggest that angioplasty may have had a short term benefit, but this may not have been sustained.

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