ABSTRACT Background: Peripheral artery disease (PAD) is a widespread circulation illness that affects 200 million people worldwide, particularly the elderly and those with pre-existing cardiac issues. Procedures to restore blood flow are required when PAD gets severe enough to endanger the limb and cause ischemia. This meta-analysis compares the effectiveness and safety of using angioplasty versus combining atherectomy with angioplasty in treating arterial disease (PAD) in adults. Methods: Following PRISMA guidelines, PubMed, Google Scholar, Cochrane CENTRAL, and Herdin databases were searched for randomized controlled trials comparing patients diagnosed with peripheral artery disease (PAD) who are candidates for revascularization procedures, specifically in an inpatient setting. Primary outcome measures included Patency rates, Limb salvage rates, Mortality rates and Functional capacity. Risk of bias was assessed using Cochrane’s tool, and analysis used a random effects model. Results: Five RCTs involving 658 patients met inclusion criteria. Pooled data showed that Artherectomy had give slight improvement in technical success however, a significant benefit was observed in reducing the need for bailout or provisional stenting. In terms of long-term patency, there was no significant difference between the atherectomy and angioplasty groups at both one and two years (p>0.05 for both). Conclusion: The combination of angioplasty with atherectomy appears to provide immediate technical advantages, unlike in long-term outcomes related to patency, mortality, and functional improvement may not significantly differ from angioplasty alone. This suggests that atherectomy might offer some early advantages in preventing these serious complications. Overall, while the findings favor the combined approach in specific immediate outcomes, they highlight the need for careful consideration in clinical practice, especially regarding long-term patient management.
Aniban et al. (Fri,) studied this question.