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Overuse of invasive interventions for patients with peripheral arterial disease and intermittent claudication has attracted considerable attention recently — in both the medical literature (NEJM JW Gen Med Apr 15 2023 and J Vasc Surg 2023; 77:836) and the public media. To provide additional perspective, researchers have conducted this meta-analysis of randomized trials that compared exercise therapy and endovascular or open revascularization. Nine trials, involving nearly 1500 patients with intermittent claudication but no evidence of limb-threatening ischemia, were identified.
During mean follow-up of 3.5 years, the following outcomes were noted for revascularization compared with exercise therapy:
Rates of progression to chronic limb-threat…