TY - JOUR
T1 - Selective-versus-standard poststent dilation for carotid artery disease
T2 - A systematic review and meta-analysis
AU - Petr, X. O.
AU - Brinjikji, W.
AU - Murad, M. H.
AU - Glodny, B.
AU - Lanzino, G.
N1 - Publisher Copyright:
© Copyright 2016 Stryker.
PY - 2017/5
Y1 - 2017/5
N2 - 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. DATA ANALYSIS: A random-effects meta-analysis was used to pool the following outcomes: periprocedural stroke/TIA, procedurerelated neurologic/cardiovascular morbidity/mortality, bradycardia/hypotension, long-term stroke at last follow-up, long-term primary patency, and technical success. DATA SYNTHESIS: 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 procedurerelated mortality of 0.9%. There were no significant differences between both groups in the incidence of restenosis (P =.93) or procedurerelated 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.
AB - 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. DATA ANALYSIS: A random-effects meta-analysis was used to pool the following outcomes: periprocedural stroke/TIA, procedurerelated neurologic/cardiovascular morbidity/mortality, bradycardia/hypotension, long-term stroke at last follow-up, long-term primary patency, and technical success. DATA SYNTHESIS: 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 procedurerelated mortality of 0.9%. There were no significant differences between both groups in the incidence of restenosis (P =.93) or procedurerelated 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.
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U2 - 10.3174/ajnr.A5103
DO - 10.3174/ajnr.A5103
M3 - Review article
C2 - 28302610
AN - SCOPUS:85019893988
SN - 0195-6108
VL - 38
SP - 999
EP - 1005
JO - American Journal of Neuroradiology
JF - American Journal of Neuroradiology
IS - 5
ER -