Editor's Choice – Drug Coated Balloon Angioplasty vs. Standard Percutaneous Transluminal Angioplasty in Below the Knee Peripheral Arterial Disease: A Systematic Review and Meta-Analysis

Autor: Eline Huizing, Jean-Paul P.M. de Vries, Çağdaş Ünlü, Michiel A Schreve, Jetty Ipema
Rok vydání: 2020
Předmět:
Cost effectiveness
ELUTING BALLOON
medicine.medical_treatment
030204 cardiovascular system & hematology
030230 surgery
law.invention
COST-EFFECTIVENESS
0302 clinical medicine
Coated Materials
Biocompatible
Randomized controlled trial
Restenosis
INFRAPOPLITEAL ARTERIES
law
CRITICAL LIMB ISCHEMIA
Popliteal Artery
Drug-Eluting Stents
Percutaneous transluminal angioplasty
Limb Salvage
Femoral Artery
Treatment Outcome
Meta-analysis
REVASCULARIZATION
medicine.symptom
Cardiology and Cardiovascular Medicine
INTERVENTIONS
medicine.medical_specialty
Drug coated balloon
Paclitaxel
Amputation
Surgical
03 medical and health sciences
Internal medicine
Angioplasty
Peripheral arterial disease
MANAGEMENT
medicine
Humans
MULTILEVEL TREATMENT
Survival rate
Vascular Patency
business.industry
Odds ratio
Critical limb ischemia
medicine.disease
Survival Analysis
RANDOMIZED-TRIAL
CATHETER
Systematic review
Surgery
business
Angioplasty
Balloon
Zdroj: European Journal of Vascular and Endovascular Surgery. 59:265-275
ISSN: 1078-5884
DOI: 10.1016/j.ejvs.2019.10.002
Popis: Objectives The aim was to review and analyse the literature on clinical outcomes of drug coated balloon (DCB) vs. standard percutaneous transluminal angioplasty (PTA) for the treatment of infrapopliteal arterial disease. Methods This is a systematic review and meta-analysis. The MEDLINE, EMBASE and Cochrane Database of Systematic Reviews were searched for studies published between January 2008 and November 2018. Two authors independently performed the search, study selection, assessment of methodological quality and data extraction. Studies were eligible when reporting PTA and DCB outcomes in infrapopliteal arteries, published in English, human studies, and full text was available. Methodological quality was determined by MINORS and Cochrane risk of bias tool. GRADE methodology was used to rate the evidence for observed outcomes. The primary outcome was the 12 month limb salvage rate. Secondary outcomes were 12 month survival, amputation free survival (AFS), restenosis, and target lesion revascularisation (TLR) rates. Inclusion criteria for pooling data were randomised controlled trials and comparative studies with 12 month outcomes. Results Ten studies representing 1593 patients met the inclusion criteria. The quality was assessed as moderate or low. Data from five studies were pooled, and 12 month outcomes for DCB vs. PTA were limb salvage rate, 94.0% vs. 95.7% (odds ratio (OR), 0.92; 95% confidence interval (CI), 0.39–2.21); and survival rate, 89.8% vs. 92.9% (OR 0.69; 95% CI 0.39–1.21). Data from four studies were pooled, and 12 month outcomes for PTA vs. DCB were restenosis rate, 62.0% vs. 32.9% (OR 2.87; 95% CI 0.83–9.92); and TLR rate, 27.8% vs. 14.0% (OR 2.76; 95% CI 0.90–8.48). Pooled data from two studies showed 12 month AFS rate for DCB vs. PTA; 82.5% vs. 88.7% (OR 0.79; 95% CI 0.23–2.75). No statistically significant differences were found. Conclusion Based on this systematic review and meta-analysis no significant differences in limb salvage, survival, restenosis, TLR, and AFS rates were found when DCB angioplasty was compared with standard PTA.
Databáze: OpenAIRE
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