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Chelation therapy does not reverse peripheral arterial occlusive disease

Clinical bottom line: Chelation therapy is not effective in reducing the symptoms of peripheral arterial occlusive disease.

Chelation therapy involves repeated intravenous administration of EDTA, usually alongside supplementation with vitamins, trace elements and iron. The process binds ions in the blood; binding to calcium may help break down arteriosclerotic plaques.


Systematic review:

Ernst E. Chelation therapy for peripheral arterial occlusive disease. A systematic review. Circulation 1997; 96:1031-1033.

Date review completed: 1996

Number of trials included: 4

Number of patients: (225 total)

Control groups: Placebo.

Main outcomes: walking distance, ankle/arm blood pressure, transcutaneous oxygen levels, angiogram.

Inclusion criteria were randomised, double blind, placebo controlled trials which assessed chelation therapy for the treatment of peripheral arterial occlusive disease.

Medline (1966-1996) and CISCOM (1996) were searched for relevant published studies. Bibliographies of retrieved reports were scanned, and experts and national societies were contacted for additional citations.


Four trials which assessed chelation therapy in intermittent claudication were included. Either 10 or 20 infusions of EDTA, mainly 500-1000 ml, using chelation therapy were assessed over 5-9 or 20 weeks. None of the studies showed any beneficial effect of chelation therapy with EDTA compared with placebo.

Adverse effects

Adverse effects were not mentioned in the description of the individual trials. The reviewer's did state that EDTA is associated with serious adverse effects (e.g. hypocalcemia, severe kidney damage).



One study was of poor methodological quality: 10 treatments were conducted in a double blind manner but a further 10 treatments were conducted under single (patient) blind conditions. The length of follow up was not stated and the outcomes were not clearly defined. The other studies were stated to be of high quality. All studies showed that chelation therapy with EDTA is not effective in the treatment of peripheral arterial occlusive disease.

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