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Meta-Analysis
. 2010 Jan 20;2010(1):CD003228.
doi: 10.1002/14651858.CD003228.pub2.

Endovascular stents for intermittent claudication

Paul Bachoo  1 , P A Thorpe, Heather Maxwell, Karen Welch
Affiliations
Meta-Analysis

Endovascular stents for intermittent claudication

Paul Bachoo et al. Cochrane Database Syst Rev. .

Abstract

Background: Endovascular stents have been suggested as a means to improve the patency of arteries after angioplasty in patients with intermittent claudication. This is an update of a Cochrane review published in 2002.

Objectives: The null hypothesis to be tested by this review is that for individuals with claudication the use of an endovascular stent, in addition to percutaneous transluminal angioplasty, does not improve symptoms of life-style limiting claudication when compared to percutaneous angioplasty alone.

Search strategy: For this update the Cochrane Peripheral Vascular Diseases Group searched their Specialised Register (last searched August 2009) and the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (last searched 2009, Issue 3).

Selection criteria: Randomised trials comparing angioplasty alone versus angioplasty with endovascular stents in patients with intermittent claudication.

Data collection and analysis: Two authors independently assessed trial quality and extracted the data. Only published trial data were used but unpublished data were sought for the update. Effectiveness was measured by the pre-defined primary outcome measures restenosis or reocclusion rates and maximum walking distance.

Main results: Two studies were included involving a total of 104 participants. Both studies included only individuals with femoro-popliteal disease. They compared angioplasty and stenting with the Palmaz stent against angioplasty alone. Although one study showed a slight statistical advantage in arterial patency after angioplasty alone, this was not found when the two studies were combined. No differences in the secondary outcomes were detected in either study.

Authors' conclusions: The small number of relevant studies identified together with the small sample sizes and methodological weaknesses severely limit the usefulness of this review in guiding practice. The results from larger multicentre trials are needed.

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Conflict of interest statement

None known.

Figures

1
1
Flow‐chart of study selection
2
2
Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
3
3
Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
1.1
1.1. Analysis
Comparison 1 Primary outcome measure, Outcome 1 Duplex scan confirmed stenosis or occlusion.
2.1
2.1. Analysis
Comparison 2 Walking distance, Outcome 1 Post intervention treadmill walking distance.
3.1
3.1. Analysis
Comparison 3 Clinical end points, Outcome 1 Post intervention morbidity.
3.2
3.2. Analysis
Comparison 3 Clinical end points, Outcome 2 Failed treatment requiring reintervention.
3.3
3.3. Analysis
Comparison 3 Clinical end points, Outcome 3 Patient reported deterioration at 12 months post intvention.
4.1
4.1. Analysis
Comparison 4 Physiological measures, Outcome 1 ABPI.
5.1
5.1. Analysis
Comparison 5 Other non pre‐defined outcome measures, Outcome 1 Technical failure.
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References

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