Endovascular Treatment for Intermittent Claudication in Patients with Peripheral Arterial Disease: A Systematic Review

BackgroundWe performed a systematic review and meta-analysis to examine whether patients with intermittent claudication can benefit from endovascular treatment (EVT).MethodsA 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.ResultsThe 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.ConclusionsPatients 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.