Self-expanding versus balloon expandable stent for intracranial arterial stenosis: A systematic review and meta-analysis

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging Pub Date : 2024-01-15 DOI:10.1111/jon.13188

Adnan I. Qureshi, Abdullah Lodhi, Xiaoyu Ma, Rehan Ahmed, Chun Shing Kwok, Hamza Maqsood, Jahanzeb Liaqat, Ameer E. Hassan, Farhan Siddiq, Camilo R. Gomez, M. Fareed K. Suri

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引用次数: 0

Abstract

Background and Purpose

There are limited data regarding the comparison of balloon expandable stents (BES) and self-expanding stents (SES) for the treatment of intracranial arterial stenosis.

Methods

We conducted a systematic review to identify studies that compared SES and BES in patients with symptomatic intracranial arterial stenosis. Data were extracted from relevant studies found through a search of PubMed, Scopus, and Web of Science until from January 1, 2010 to September 28, 2023. Statistical pooling with random-effects meta-analysis was undertaken to compare the rates/severity of postprocedure stenosis, technical success, 30-day stroke and/or death, cumulative clinical endpoints, and restenosis rates.

Results

A total of 20 studies were included. The standardized mean difference (SMD) for postprocedure stenosis (%) was significantly lower (SMD: −0.52, 95% confidence interval [CI]: −0.79 to −0.24, p < .001, 10 studies involving 1515 patients) with BES. The odds for 30-day stroke and/or death were significantly lower (odds ratio [OR] 0.68, 95% CI: 0.50-0.94, p = .019, 15 studies involving 2431 patients), and cumulative clinical endpoints on follow-up were nonsignificantly lower (OR 0.64, 95% CI: 0.30-1.37, p = .250, 10 studies involving 947 patients) with BES. The odds for restenosis during follow-up were significantly lower (OR 0.50, 95% CI: 0.31-0.80, p = .004, 13 studies involving 1115 patients) with BES.

Conclusions

Compared with SES, BES were associated with lower rates of postprocedure 30-day stroke and/or death with lower rates of restenosis during follow up and the treatment of symptomatic intracranial arterial stenosis.

查看原文本刊更多论文

治疗颅内动脉狭窄的自膨胀支架与球囊扩张支架：系统回顾和荟萃分析。

背景和目的：关于球囊扩张支架（BES）和自扩张支架（SES）治疗颅内动脉狭窄的比较数据有限：我们进行了一项系统性回顾，以确定在有症状的颅内动脉狭窄患者中比较 SES 和 BES 的研究。数据摘自2010年1月1日至2023年9月28日在PubMed、Scopus和Web of Science上搜索到的相关研究。通过随机效应荟萃分析进行统计汇总，比较术后血管狭窄的发生率/严重程度、技术成功率、30天卒中和/或死亡、累积临床终点和再狭窄率：结果：共纳入 20 项研究。BES术后血管狭窄的标准化平均差（SMD）（%）明显更低（SMD：-0.52，95%置信区间[CI]：-0.79至-0.24，P < .001，10项研究涉及1515名患者）。BES 可显著降低 30 天卒中和/或死亡的几率（几率比 [OR] 0.68，95% 置信区间 [CI]：0.50-0.94，p = .019，涉及 2431 名患者的 15 项研究），随访期间累积临床终点的几率（OR 0.64，95% 置信区间 [CI]：0.30-1.37，p = .250，涉及 947 名患者的 10 项研究）非显著降低。BES的随访期间再狭窄几率显著降低（OR 0.50，95% CI：0.31-0.80，p = .004，13项研究，涉及1115名患者）：结论：与 SES 相比，BES 术后 30 天中风和/或死亡的发生率较低，随访期间再狭窄的发生率也较低，可用于无症状颅内动脉狭窄的治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neuroimaging 医学-核医学

CiteScore

4.70

自引率

0.00%

发文量

117

审稿时长

6-12 weeks

期刊介绍： Start reading the Journal of Neuroimaging to learn the latest neurological imaging techniques. The peer-reviewed research is written in a practical clinical context, giving you the information you need on: MRI CT Carotid Ultrasound and TCD SPECT PET Endovascular Surgical Neuroradiology Functional MRI Xenon CT and other new and upcoming neuroscientific modalities.The Journal of Neuroimaging addresses the full spectrum of human nervous system disease, including stroke, neoplasia, degenerating and demyelinating disease, epilepsy, tumors, lesions, infectious disease, cerebral vascular arterial diseases, toxic-metabolic disease, psychoses, dementias, heredo-familial disease, and trauma.Offering original research, review articles, case reports, neuroimaging CPCs, and evaluations of instruments and technology relevant to the nervous system, the Journal of Neuroimaging focuses on useful clinical developments and applications, tested techniques and interpretations, patient care, diagnostics, and therapeutics. Start reading today!