Randomised controlled trial of percutaneous transluminal angioplasty for intermittent claudication.
OBJECTIVE
To determine differences between PTA and conventional medical treatment in treadmill distance until onset of claudication, treadmill maximum walking distance, patient reported maximum walking distance, ankle brachial pressure index (ABPI), quality of life (Nottingham Health Profile, NHP) and Duplex measured extent of occlusive disease.


METHODS
Randomised controlled clinical trial.


METHODS
Six hundred claudicants were screened. Fifty-one men and 11 women with intermittent claudication due to short femoral stenoses or occlusions (n = 47) and iliac stenoses (n = 15) were randomised to either PTA plus medical treatment (PTA group, n = 30) or to medical treatment alone (control group, n = 32). Medical treatment consisted of daily low dose aspirin and advice on smoking and exercise.


RESULTS
At 6 month follow up: In the PTA group more patients reported no claudication (p < or = 0.05) and were asymptomatic on the treadmill (p < or = 0.01) compared to the control group. The ABPI was significantly higher in the PTA group. More of the PTA group reported lower NHP pain scores (p < or = 0.05). In the control group there were more occluded arteries (p < or = 0.001), and the stenosis velocity ratio of patient arteries was significantly higher (p < or = 0.001).


CONCLUSIONS
Only 10% of claudicants had discrete lesions suitable for PTA. Treatment of these patients with PTA produces a greater short-term improvement in walking and quality of life than medical treatment alone and is associated with less progression of disease.
Whyman
M R
MR
Wolfson Unit for Prevention of Peripheral Vascular Diseases, Department of Public Health Sciences, University of Edinburgh, U.K.
Fowkes
F G
FG
Kerracher
E M
EM
Gillespie
I N
IN
Lee
A J
AJ
Housley
E
E
Ruckley
C V
CV
D000800:Angioplasty, Balloon; D001241:Aspirin / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D005263:Femoral Artery; D005500:Follow-Up Studies; D006801:Humans; D007083:Iliac Artery; D007383:Intermittent Claudication / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011788:Quality of Life; D013997:Time Factors; D014654:Vascular Patency / Q000502:physiology; D016138:Walking / Q000502:physiology
D010975:Platelet Aggregation Inhibitors; D001241:Aspirin