George N Kouvelos1, Nikolaos Patelis2, George A Antoniou3, Andreas Lazaris4, Miltiadis I Matsagkas5. 1. Department of Surgery, Vascular Surgery Unit, Medical School, University of Ioannina, Greece. 2. First Department of Surgery, Vascular Surgery Unit, Medical School, University of Athens, Greece. 3. Liverpool Vascular and Endovascular Service, Royal Liverpool University Hospital, Liverpool, UK. 4. Third Department of Surgery, Vascular Surgery Unit, University of Athens, Greece. 5. Department of Surgery, Vascular Surgery Unit, Medical School, University of Ioannina, Greece mimats@cc.uoi.gr.
Abstract
PURPOSE: To review the contemporary literature and analyze whether stent cell design plays a role in 30-day outcomes after carotid artery stenting (CAS). METHODS: A systematic review of the literature was undertaken that identified 9 studies comparing the effect of different cell design on 30-day outcome in patients undergoing CAS. Random-effects models were applied to calculate pooled outcome data for mortality and cerebrovascular morbidity. Results are reported as the odds ratio (OR) and 95% confidence interval (CI). RESULTS: The 9 studies included 8018 patients who underwent 8028 CAS procedures (4018 open-cell stents, 4010 closed-cell stents). Six studies were retrospective in design, one was a registry, and only two studies prospectively compared the effect of different cell designs. Nearly half of the patients (3452, 43.1%) were symptomatic, with no significant difference between the closed- and open-cell stent groups (p=0.93). During the first month after the procedure, there were no significant differences in mortality (OR 0.69, 95% CI 0.39 to 1.24, p=0.21), transient ischemic attacks (OR 0.95, 95% CI 0.69 to 1.30, p=0.74), or strokes (OR 1.17, 95% CI 0.83 to 1.66, p=0.37). CONCLUSION: This meta-analysis showed that 30-day cerebrovascular complications after CAS were not significantly different for the open-cell group in comparison to the closed-cell group. Future prospective clinical trials comparing different free cell areas and other stent design properties are still needed to further investigate whether stent design plays a significant role in the results of carotid stenting.
PURPOSE: To review the contemporary literature and analyze whether stent cell design plays a role in 30-day outcomes after carotid artery stenting (CAS). METHODS: A systematic review of the literature was undertaken that identified 9 studies comparing the effect of different cell design on 30-day outcome in patients undergoing CAS. Random-effects models were applied to calculate pooled outcome data for mortality and cerebrovascular morbidity. Results are reported as the odds ratio (OR) and 95% confidence interval (CI). RESULTS: The 9 studies included 8018 patients who underwent 8028 CAS procedures (4018 open-cell stents, 4010 closed-cell stents). Six studies were retrospective in design, one was a registry, and only two studies prospectively compared the effect of different cell designs. Nearly half of the patients (3452, 43.1%) were symptomatic, with no significant difference between the closed- and open-cell stent groups (p=0.93). During the first month after the procedure, there were no significant differences in mortality (OR 0.69, 95% CI 0.39 to 1.24, p=0.21), transient ischemic attacks (OR 0.95, 95% CI 0.69 to 1.30, p=0.74), or strokes (OR 1.17, 95% CI 0.83 to 1.66, p=0.37). CONCLUSION: This meta-analysis showed that 30-day cerebrovascular complications after CAS were not significantly different for the open-cell group in comparison to the closed-cell group. Future prospective clinical trials comparing different free cell areas and other stent design properties are still needed to further investigate whether stent design plays a significant role in the results of carotid stenting.
Authors: Paweł Latacz; Marian Simka; Paweł Brzegowy; Piotr Janas; Marek Kazibudzki; Piotr Pieniążek; Andrzej Ochała; Tadeusz Popiela; Tomasz Mrowiecki Journal: Postepy Kardiol Interwencyjnej Date: 2017-03-10 Impact factor: 1.426
Authors: K Kapnisis; H Seidner; M Prokopi; D Pasias; C Pitsillides; A Anayiotos; E Kaliviotis Journal: Clin Hemorheol Microcirc Date: 2019 Impact factor: 2.375