Patients with claudication who smoke may be denied the symptom improvement associated with revascularization, yet recidivism for smoking also occurs among patients who have stopped smoking in order to receive revascularization. The strategy not to directly revascularize patients with claudication who continue to smoke does not appear to maximize patient midterm QoL.

Conclusions: Very little has been published regarding the efficacy of dual-antiplatelet therapy on patency after lower extremity endovascular interventions (113 patients), limiting the usefulness of meta-analysis. The existing limited data suggests dual antiplatelet therapy may improve target artery patency, but at the possible expense of increased major bleeding. Given the imprecision of these estimates, larger cohort studies and eventual clinical trials will be necessary to determine the balance of benefits and harms of dual antiplatelet therapy for these interventions.