Angioplasty (versus non surgical management) for intermittent claudication (Cochrane Review)

A substantive amendment to this systematic review was last made on 19 February 1998. Cochrane reviews are regularly checked and updated if necessary.

Background: Intermittent 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.

Objectives: The 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 strategy: The 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 criteria: Randomised trials of angioplasty for mild or moderate intermittent claudication.

Data collection and analysis: One reviewer extracted data and both reviewers assessed trial quality independently.

Main results: Two trials with a total of 98 participants were included. The average age was 62 years old with 20 women and 78 men. Patients were followed for two years 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.

Reviewers' conclusions: These limited results suggest that angioplasty may have had a short term benefit, but this may not have been sustained.

Citation: Fowkes FGR, Gillespie IN. Angioplasty (versus non surgical management) for intermittent claudication (Cochrane Review). In: The Cochrane Library, Issue 3, 2003. Oxford: Update Software.

---

This is an abstract of a regularly updated, systematic review prepared and maintained by the Cochrane Collaboration. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).

The Cochrane Library is designed and produced by Update Software Ltd.

Update Software Ltd, Summertown Pavilion, Middle Way, Oxford OX2 7LG, UK
(Tel:+44 1865 513902; Fax:+44 1865 516918)

File Reference: AB000017.htm