| Infragenicular stent implantation for below-the-knee atherosclerotic disease: clinical evidence from an international collaborative meta-analysis on 640 patients. | |
| | |
MedLine Citation:
|
PMID: 19642789 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
PURPOSE: To report a systematic review of the literature published on the outcomes of stenting for below-the-knee disease in patients with critical limb ischemia (CLI). METHODS: Potentially relevant studies of stent implantation in the infragenicular arteries in >or=5 patients with >or=1-month follow-up were systematically sought in BioMedCentral, ClinicalTrials.gov, The Cochrane Collaboration Register of Controlled Trials (CENTRAL), Google Scholar, and PubMed. Data were abstracted and pooled with a random-effect model to generate risk estimates with 95% confidence intervals (CI). Interaction tests were performed to compare different stent types. A risk of bias assessment was conducted separately, as were appraisals for small study bias, statistical heterogeneity, and inconsistency. RESULTS: Eighteen nonrandomized studies were retrieved comprising 640 patients. After a median follow-up of 12 months, binary in-stent restenosis occurred in 25.7% (95% CI 11.6% to 40.0%), primary patency in 78.9% (95% CI 71.8% to 86.0%), improvement in Rutherford class in 91.3% (95% CI 85.5% to 97.1%), target vessel revascularization in 10.1% (95% CI 6.2% to 13.9%), and limb salvage in 96.4% (95% CI 94.7% to 98.1%). Head-to-head comparisons showed that sirolimus-eluting stents were superior to balloon-expandable bare metal stents in preventing restenosis and increasing primary patency (both p<0.001); sirolimus-eluting stents were also better than paclitaxel-eluting stents in terms of primary patency (p<0.001) and repeat revascularizations (p = 0.014). CONCLUSION: Percutaneous infragenicular stent implantation after failed or unsuccessful balloon angioplasty is associated with favorable clinical results in patients with CLI. Notwithstanding limitations of primary studies, sirolimus-eluting stents appear superior to bare metal and paclitaxel-eluting stents in terms of angiographic and/or clinical outcomes. |
| | |
Authors:
|
Giuseppe G L Biondi-Zoccai; Giuseppe Sangiorgi; Marzia Lotrionte; Andrew Feiring; Philippe Commeau; Massimiliano Fusaro; Pierfrancesco Agostoni; Marc Bosiers; Jan Peregrin; Oscar Rosales; Antonio R Cotroneo; Thomas Rand; Imad Sheiban |
Related Documents
:
|
20142219 - Misago 1: first-in-man clinical trial with misago nitinol stent. 11875089 - Nonsurgically placed nasolacrimal stents for epiphora: long-term results and factors fa... 20430849 - Emergent self-expanding stent placement for acute intracranial or extracranial internal... 9827809 - Temporal bone and lateral skull base malignancy: experience and results with 81 patients. 16128779 - Fluoroscopically guided insertion of self-expandable metal esophageal stents for pallia... 19889649 - An optical coherence tomography study of a biodegradable vs. durable polymer-coated lim... 21907969 - A free retinal pigment epithelium-choroid graft in patients with exudative age-related ... 15960629 - Effectiveness of low dose immunotherapy in the treatment of canine atopic dermatitis: a... 1475639 - Pattern of sle in hong kong chinese: a cohort study. |
Publication Detail:
|
Type: Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
|
Title: Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists Volume: 16 ISSN: 1545-1550 ISO Abbreviation: J. Endovasc. Ther. Publication Date: 2009 Jun |
Date Detail:
|
Created Date: 2009-07-31 Completed Date: 2009-11-13 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 100896915 Medline TA: J Endovasc Ther Country: United States |
Other Details:
|
Languages: eng Pagination: 251-60 Citation Subset: IM |
Affiliation:
|
Division of Cardiology, University of Turin, Italy. gbiondizoccai@gmail.com |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Angioplasty* Atherosclerosis / therapy* Equipment Design Humans Leg / blood supply* Peripheral Vascular Diseases / therapy* Stents* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Nitinol stent implantation in long superficial femoral artery lesions: 12-month results of the DURAB...
Next Document: An experimental and numerical comparison of the rupture locations of an abdominal aortic aneurysm.