MIMIC: Angioplasty better for mild to moderate intermittent claudication

Results from the MIMIC trial were presented at the recent British Society of Interventional Radiology and the Vascular Society of Great Britain and Ireland meetings.
Percutaneous transluminal angioplasty has adjuvant benefit for patients with stable mild to moderate intermittent claudication in two randomised controlled trials for aorto-iliac and femoropopliteal lesions in addition to supervised exercise, smoking cessation and best medical therapy.

Ninety-three patients of mean age 66 were randomised to a femoropopliteal arm (48 to PTA) and 34 of mean age 63 to an aorto-iliac arm (19 to PTA). Follow-up at 24 months showed improvements: the primary endpoint of Absolute Walking Distance (AWD) was 38% greater in the PTA/femoropopliteal group (95% CI 1 to 90) and 78% greater in the PTA/aortoiliac group. Further benefits were observed in terms of Ankle Brachial Pressure Index; there was no change in quality of life. These are the first randomised controlled trials to show the efficacy of angioplasty. The trials were supported by educational grails from Bard, Boston Scientific and Cook.