Robust clinical and scientific data to support the use of angioplasty or exercise for intermittent claudication are scanty. The purpose of this article is to explore the evidence for each of these treatments. A computer search of relevant published material. Very few randomised controlled trials are available on which to base a sound treatment policy. Currently, the evidence in favour of exercise therapy for short term improvement in symptoms is more compelling than that for angioplasty. The mechanisms of action, the magnitude of effects on walking, the relative efficacy and the hazards of the treatments are discussed. The only way to seriously address the question of which treatment is best for claudicants is by means of the randomised trial and until this has been done angioplasty will remain an expensive treatment of unproven benefit for claudication.
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