Editor's Perspective Lessons Learned from Recent Randomized Clinical Trials for Intermittent Claudication

been reported. The focuses of the trials were exercise therapy and endovascular revascularization. The studies add to our understanding of the relative benefits of these therapies in IC and highlight the ongoing challenge in performing randomized clinical trials in this population. Although the trials were small, the lessons we learned from them are big. The first study, published in Circulation, is the 6-month outcomes from the Claudication: Exercise Versus Endoluminal Revascularization (CLEVER) study.10 This trial was designed to compare 3 therapies previously shown to be effective in the treatment of IC: optimal medical care (OMC), alone or in combination with supervised exercise or stent revascularization. Patients were randomized in a 1:2:2 fashion. The study initially had a fourth arm of stent therapy and supervised exercise, but unfortunately this was halted due to slow recruitment. The study was restricted to patients with aortoiliac disease, although concomitant treatment of