Endovascular treatment for intermittent claudication in patients with peripheral arterial disease: a systematic review

Ann Vasc Surg. 2014 May;28(4):977-82. doi: 10.1016/j.avsg.2013.05.022. Epub 2013 Dec 14.

Abstract

Background: We performed a systematic review and meta-analysis to examine whether patients with intermittent claudication can benefit from endovascular treatment (EVT).

Methods: A prespecified search strategy was used to identify relevant studies in the MEDLINE, Embase, and Cochrane databases. A total of 10 different randomized, controlled trials were reviewed. Random effects meta-analysis was performed between the EVT plus conservative treatment (CT) group and the CT group alone. Also, random effects meta-analysis was performed between the EVT group and the supervised exercise therapy (SET) group.

Results: The independent effect of EVT could directly improve the ankle-brachial index (ABI) and walking performance over the short term, but not over the long term. Moreover, compared to SET, EVT had the superiority in improving the ABI, while SET could improve walking performance more efficiently.

Conclusions: Patients with intermittent claudication may benefit from endovascular treatment over the short term (within 12 months), with improvements in ABI, intermittent claudication distance, and maximum walking distance. However, considering improvements on walking performance (especially over the long term), SET is recommended.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Ankle Brachial Index
  • Chi-Square Distribution
  • Endovascular Procedures*
  • Exercise Therapy
  • Exercise Tolerance
  • Humans
  • Intermittent Claudication / diagnosis
  • Intermittent Claudication / physiopathology
  • Intermittent Claudication / therapy*
  • Peripheral Arterial Disease / diagnosis
  • Peripheral Arterial Disease / physiopathology
  • Peripheral Arterial Disease / therapy*
  • Recovery of Function
  • Time Factors
  • Treatment Outcome
  • Walking