Selective-versus-standard poststent dilation for carotid artery disease: A systematic review and meta-analysis

X. O. Petr, Waleed Brinjikji, Mohammad H Murad, B. Glodny, G. Lanzino

Research output: Contribution to journalReview article

3 Citations (Scopus)

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. 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.

Original languageEnglish (US)
Pages (from-to)999-1005
Number of pages7
JournalAmerican Journal of Neuroradiology
Volume38
Issue number5
DOIs
StatePublished - May 1 2017

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Carotid Artery Diseases
Angioplasty
Meta-Analysis
Dilatation
Carotid Arteries
Stents
Stroke
Safety
Balloon Angioplasty
Mortality
Carotid Stenosis
Bradycardia
MEDLINE
Hypotension
Nervous System
Morbidity
Incidence

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

Cite this

Selective-versus-standard poststent dilation for carotid artery disease : A systematic review and meta-analysis. / Petr, X. O.; Brinjikji, Waleed; Murad, Mohammad H; Glodny, B.; Lanzino, G.

In: American Journal of Neuroradiology, Vol. 38, No. 5, 01.05.2017, p. 999-1005.

Research output: Contribution to journalReview article

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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. 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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