Eversion technique versus conventional endarterectomy with patch angioplasty in carotid surgery
| Autor: | Ronald L. A. W. Bleys, Frans L. Moll, Martijn S. Marsman, G. G. Koning, Abdelkarime Kh. Jahrome, Frederik Keus, Jørn Wetterslev, P. W. H. E. Vriens |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
LIMITATIONS
medicine.medical_specialty OCCLUSION medicine.medical_treatment MEDLINE Carotid endarterectomy SYMPTOMATIC PATIENTS GUIDELINES vascular surgery STENOSIS MONITORING BOUNDARIES Bias medicine.artery medicine Humans Carotid Stenosis Stroke Endarterectomy Randomized Controlled Trials as Topic RISK Endarterectomy Carotid CEREBRAL-ISCHEMIA business.industry Data Collection Angioplasty General Medicine Vascular surgery medicine.disease stroke Clinical trial Systematic review Carotid Arteries GRADE Emergency medicine DESIGN CHARACTERISTICS Quality of Life Surgery Internal carotid artery business head & neck surgery |
| Zdroj: | BMJ Open |
| ISSN: | 2044-6055 |
| DOI: | 10.1136/bmjopen-2019-030503 |
| Popis: | IntroductionTraditional carotid endarterectomy is considered to be the standard technique for prevention of a new stroke in patients with a symptomatic carotid stenosis. Use of patch angioplasty to restore the arterial wall after longitudinal endarterectomy is, to date, not unequivocally proven to be superior to eversion technique. A systematic review is needed for evaluation of benefits and harms of the eversion technique versus the traditional endarterectomy with patch angioplasty in patients with symptomatic carotid stenosis.Methods and outcomesThe review will be conducted according to this protocol following the recommendations of the ‘Cochrane Handbook for Systematic Reviews’ and reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Randomised clinical trials comparing eversion technique versus endarterectomy with patch angioplasty in patients with a symptomatic stenosis of the internal carotid artery will be included. Primary outcomes are all-cause mortality rate, health-related quality of life and serious adverse events. Secondary outcomes are 30-day stroke and mortality rate, symptomatic arterial restenosis or occlusion and non-serious adverse events. The databases Cochrane Central Register of Controlled Trials, PubMed/MEDLINE and EMBASE will be searched (November 2019). We will primarily base our conclusions on meta-analyses of trials with overall low-risk of bias. We will use trial sequential analysis to assist the evaluation of imprecision in Grading of Recommendations, Assessment, Development and Evaluation. However, if pooled point estimates of all trials are similar to pooled point estimates of trials with overall low risk of bias and there is lack of a statistical significant interaction between estimates from trials with overall high risk of bias and trials with overall low risk of bias we will consider the trial sequential analysis adjusted precision of the estimate achieved in all trials as the result of our meta-analyses.Ethics and disseminationThe proposed systematic review will collect and analyse data from published studies, therefore, ethical approval is not required. The results of the review will be disseminated by publication in a peer-review journal and submitted for presentation at conferences.PROSPERO registration numberCRD42019119361. |
| Databáze: | OpenAIRE |
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