Selective-versus-Standard Poststent Dilation for Carotid Artery Disease: A Systematic Review and Meta-Analysis.
AJNR Am J Neuroradiol
; 38(5): 999-1005, 2017 May.
Article
em En
| MEDLINE
| ID: mdl-28302610
ABSTRACT
BACKROUND The safety and efficacy of standard poststent angioplasty in patients undergoing carotid artery stent placement have not been well-established. PURPOSE:
We conducted a systematic review of the literature to evaluate the safety and efficacy of carotid artery stent placement and analyzed outcomes of standard-versus-selective poststent angioplasty. DATA SOURCES A systematic search of MEDLINE, EMBASE, Scopus, and the Web of Science was performed for studies published between January 2000 and January 2015. STUDY SELECTION We included studies with >30 patients describing standard or selective poststent angioplasty during carotid artery stent placement. DATAANALYSIS:
A random-effects meta-analysis was used to pool the followingoutcomes:
periprocedural stroke/TIA, procedure-related neurologic/cardiovascular morbidity/mortality, bradycardia/hypotension, long-term stroke at last follow-up, long-term primary patency, and technical success. DATASYNTHESIS:
We included 87 studies with 19,684 patients with 20,378 carotid artery stenoses. There was no difference in clinical (P = .49) or angiographic outcomes (P = .93) in carotid artery stent placement treatment with selective or standard poststent balloon angioplasty. Both selective and standard poststent angioplasty groups had a very high technical success of >98% and a low procedure-related mortality of 0.9%. There were no significant differences between both groups in the incidence of restenosis (P = .93) or procedure-related complications (P = .37).LIMITATIONS:
No comparison to a patient group without poststent dilation could be performed.CONCLUSIONS:
Our meta-analysis demonstrated no significant difference in angiographic and clinical outcomes among series that performed standard poststent angioplasty and those that performed poststent angioplasty in only select patients.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Stents
/
Estenose das Carótidas
/
Angioplastia com Balão
Tipo de estudo:
Systematic_reviews
Limite:
Aged
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
AJNR Am J Neuroradiol
Ano de publicação:
2017
Tipo de documento:
Article