Percutaneous angioplasty versus atherectomy for treatment of symptomatic infra-popliteal arterial disease.
Cardiovasc Revasc Med
; 19(4): 423-428, 2018 06.
Article
em En
| MEDLINE
| ID: mdl-29269152
ABSTRACT
BACKGROUND:
Outcomes for debulking by atherectomy (ATH) for adjunctive treatment of below the knee (BTK) symptomatic arterial disease compared to percutaneous transluminal angioplasty alone (PTA) are unclear.METHODS:
MEDLINE, EMBASE, PubMed and the Cochrane Central Register of Controlled Trials were queried from between 2000 and 2017 including studies comparing PTA alone to PTA-ATH. Random effect meta-analysis model was used to pool the data across the studies. Study endpoints included vessel dissection, residual stenosis (<30%), mortality at 12months and amputation rates at 1 and 12months.RESULTS:
A total of 2587 patients (72.9years; 63% male) were included from 4 studies (2 prospective, one of which was randomized, and 2 retrospective) comparing PTA alone to ATH-PTA in patients with symptomatic infra-popliteal disease. There was no significant difference between the two approaches in terms of vessel dissection [OR 3.73 with 95% CI 0.83 to 16.64, p=0.08] or residual stenosis [OR 0.41 with 95% CI 0.11 to 1.60, p=0.18]. Clinical outcomes did not differ in terms of 12month mortality [OR 3.47 with 95% CI 0.15 to 81.37, p=0.44], or limb amputation at 1month [OR 1.23 with 95% CI 0.91 to 1.67, p=0.18] or 12months [OR 1.02 with 95% CI 0.83 to 1.26, p=0.83].CONCLUSION:
In patients undergoing (BTK) intervention, PTA alone and ATH-PTA was associated with similar outcomes in terms of vessel dissection and residual stenosis, mortality at 12months, and limb amputation at 1 or 12months.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Artéria Poplítea
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Aterectomia
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Angioplastia
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Doença Arterial Periférica
Tipo de estudo:
Clinical_trials
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Diagnostic_studies
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Etiology_studies
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Prognostic_studies
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Risk_factors_studies
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Systematic_reviews
Limite:
Aged
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Female
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Humans
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Male
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article