Comparative Efficacy and Safety of Endovascular Treatment Modalities for Femoropopliteal Artery Lesions: A Network Meta-analysis of Randomized Controlled Trials
| Autor: | Zhihui Zhang, Qiang Li, Yangyong Li, Wenjia Ai, Shaomang Lin, Jian-bin Xiao, Junwei Wang, Yang Zhou |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Atherectomy medicine.medical_treatment Network Meta-Analysis Balloon Amputation Surgical 030218 nuclear medicine & medical imaging law.invention Peripheral Arterial Disease 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Self-expandable metallic stent law Angioplasty Alloys medicine Humans Popliteal Artery Radiology Nuclear Medicine and imaging Randomized Controlled Trials as Topic business.industry Endovascular Procedures Stent Drug-Eluting Stents Middle Aged Surgery Femoral Artery Treatment Outcome medicine.anatomical_structure Meta-analysis Female Stents Cardiology and Cardiovascular Medicine business Angioplasty Balloon Artery |
| Zdroj: | CardioVascular and Interventional Radiology. 43:204-214 |
| ISSN: | 1432-086X 0174-1551 |
| Popis: | We conducted a network meta-analysis of randomized controlled trials comparing the efficacy and safety of multiple endovascular treatments for femoropopliteal lesions. Nine treatments for femoropopliteal lesions were identified. We compared major amputation and all-cause mortality at 12-month follow-ups and primary patency at 6-, 12- and 24-month follow-ups of the treatments. Altogether, 26 studies (52 study arms; 4102 patients) were considered eligible. In terms of primary patency, drug-eluting stent (DES) placement was the most effective treatment at 6- and 12-month follow-ups and covered stent (CS) placement at 24-month follow-ups, whereas directional atherectomy (DA) was the least effective treatment during all follow-up periods; both DES and CS placements were better than the majority of other single treatments, including balloon angioplasty, DA, nitinol stent (NS) placement and drug-coated balloon use, during all follow-up periods. In terms of 12-month major amputation and all-cause mortality, DA was the most safe treatment, whereas NS placement was the least safe single treatment. DES and CS placements have shown encouraging results in terms of primary patency for femoropopliteal lesions, DES placement performs better within 12 months after operation and CS placement at approximately 24 months, while DA seems to be less effective. DA may be better than other treatments in terms of major amputation and all-cause mortality, while NS seems to be less safe. |
| Databáze: | OpenAIRE |
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