PURPOSE: To compare through meta-analysis the use of drug-eluting stents (DES) vs. bare metal stents (BMS) in the treatment of extracranial vertebral artery (EVA) disease. METHODS: A literature search of the PubMed database was conducted to identify English-language articles in which both BMS and DES stenting were performed for EVA stenosis by the same investigator(s). Further, eligible studies had to provide data on in-stent restenosis during follow-up. The search identified 9 nonrandomized studies that met the inclusion criteria. The random effects model was employed to pool data. Meta-regression analyses were performed to evaluate the relationships between risk of restenosis and the age of patients, the length of follow-up, or the percentage of male patients. RESULTS: Reported technical success was high (range 99.2%-100%) and comparable for BMS [100% (276/276)] and DES [99.4% (166/167)]. The use of DES was associated with significantly lower (p<0.0001) overall restenosis rates [8.2% (14/170) over follow-up periods averaging 16 to 43 months] compared to BMS [23.7% (68/287) over mean follow-up periods of 19 to 46 months]. Moreover, DES showed significantly lower symptomatic restenosis rates as compared to BMS [4.7% (8/169) for DES vs. 11.6% (32/275) for BMS; p=0.005]. There was no change in the risk of restenosis for any factor explored in the meta-regression analysis. CONCLUSION: This meta-analysis demonstrates that the use of DES for extracranial vertebral artery stenting significantly reduces both the rate of restenosis and recurrence of symptoms as compared to BMS. In future, randomized trials are needed to support these findings.
PURPOSE: To compare through meta-analysis the use of drug-eluting stents (DES) vs. bare metal stents (BMS) in the treatment of extracranial vertebral artery (EVA) disease. METHODS: A literature search of the PubMed database was conducted to identify English-language articles in which both BMS and DES stenting were performed for EVA stenosis by the same investigator(s). Further, eligible studies had to provide data on in-stent restenosis during follow-up. The search identified 9 nonrandomized studies that met the inclusion criteria. The random effects model was employed to pool data. Meta-regression analyses were performed to evaluate the relationships between risk of restenosis and the age of patients, the length of follow-up, or the percentage of male patients. RESULTS: Reported technical success was high (range 99.2%-100%) and comparable for BMS [100% (276/276)] and DES [99.4% (166/167)]. The use of DES was associated with significantly lower (p<0.0001) overall restenosis rates [8.2% (14/170) over follow-up periods averaging 16 to 43 months] compared to BMS [23.7% (68/287) over mean follow-up periods of 19 to 46 months]. Moreover, DES showed significantly lower symptomatic restenosis rates as compared to BMS [4.7% (8/169) for DES vs. 11.6% (32/275) for BMS; p=0.005]. There was no change in the risk of restenosis for any factor explored in the meta-regression analysis. CONCLUSION: This meta-analysis demonstrates that the use of DES for extracranial vertebral artery stenting significantly reduces both the rate of restenosis and recurrence of symptoms as compared to BMS. In future, randomized trials are needed to support these findings.
Authors: Man Kwun Andrew Li; Anderson Chun On Tsang; Frederick Chun Pong Tsang; Wai Shing Ho; Raymand Lee; Gilberto Ka Kit Leung; Wai Man Lui Journal: Clin Neuroradiol Date: 2018-07-23 Impact factor: 3.649
Authors: Damian R Maciejewski; Łukasz Tekieli; Roman Machnik; Anna Kabłak-Ziembicka; Tadeusz Przewłocki; Piotr Paluszek; Mariusz Trystuła; Robert Musiał; Karolina Dzierwa; Piotr Pieniążek Journal: Postepy Kardiol Interwencyjnej Date: 2017-05-30 Impact factor: 1.426
Authors: Damian R Maciejewski; Piotr Pieniazek; Lukasz Tekieli; Piotr Paluszek; Tadeusz Przewlocki; Tomasz Tomaszewski; Roman Machnik; Mariusz Trystula; Jacek Legutko; Anna Kablak-Ziembicka Journal: Postepy Kardiol Interwencyjnej Date: 2019-09-18 Impact factor: 1.426