Transcatheter interventions for the treatment of peripheral atherosclerotic lesions: Part II

Transcatheter endovascular procedures are increasingly used to treat sympto matic peripheral atherosclerosis. This second part of a two-part review ass esses the existing supportive evidence for the application of recently intr oduced transcatheter treatments for lesions that cause cerebrovascular isch emia and stroke. Studies were identified via MEDLINE (January 1993 through April 1999) and reference lists of identified articles. When multicenter pr ospective randomized trials or other high-quality studies were unavailable, studies with at least 50 patients per treated group and a minimum follow-u p duration of 6 months were included. For each application, the authors ass essed the quality of evidence (efficacy, safety, and, where available, cost -effectiveness) and made recommendations with appropriate caveats. Although recommendations based on proven efficacy and cost-effectiveness cannot be made in general, the use of transcatheter therapies can be supported in spe cific circumstances based on expected reduction in procedure-related morbid ity and/or mortality. It is hoped that the identification of deficiencies i n the literature will inform and inspire critically needed research in this area.