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Meta-Analysis
. 2017 May;38(5):999-1005.
doi: 10.3174/ajnr.A5103. Epub 2017 Mar 16.

Selective-versus-Standard Poststent Dilation for Carotid Artery Disease: A Systematic Review and Meta-Analysis

O Petr  1   2 , W Brinjikji  3 , M H Murad  4 , B Glodny  5 , G Lanzino  6   3
Affiliations
Meta-Analysis

Selective-versus-Standard Poststent Dilation for Carotid Artery Disease: A Systematic Review and Meta-Analysis

O Petr et al. AJNR Am J Neuroradiol. 2017 May.

Abstract

Backround: The safety and efficacy of standard poststent angioplasty in patients undergoing carotid artery stent placement have not been well-established.

Purpose: We conducted a systematic review of the literature to evaluate the safety and efficacy of carotid artery stent placement and analyzed outcomes of standard-versus-selective poststent angioplasty.

Data sources: A systematic search of MEDLINE, EMBASE, Scopus, and the Web of Science was performed for studies published between January 2000 and January 2015.

Study selection: We included studies with >30 patients describing standard or selective poststent angioplasty during carotid artery stent placement.

Data analysis: A random-effects meta-analysis was used to pool the following outcomes: periprocedural stroke/TIA, procedure-related neurologic/cardiovascular morbidity/mortality, bradycardia/hypotension, long-term stroke at last follow-up, long-term primary patency, and technical success.

Data synthesis: We included 87 studies with 19,684 patients with 20,378 carotid artery stenoses. There was no difference in clinical (P = .49) or angiographic outcomes (P = .93) in carotid artery stent placement treatment with selective or standard poststent balloon angioplasty. Both selective and standard poststent angioplasty groups had a very high technical success of >98% and a low procedure-related mortality of 0.9%. There were no significant differences between both groups in the incidence of restenosis (P = .93) or procedure-related complications (P = .37).

Limitations: No comparison to a patient group without poststent dilation could be performed.

Conclusions: Our meta-analysis demonstrated no significant difference in angiographic and clinical outcomes among series that performed standard poststent angioplasty and those that performed poststent angioplasty in only select patients.

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Figures

Fig 1.
Fig 1.
A flow diagram describing our comprehensive literature search.
See this image and copyright information in PMC

Comment in

  • Reply.
    Petr O, Brinjikji W, Murad MH, Glodny B, Lanzino G. Petr O, et al. AJNR Am J Neuroradiol. 2017 Nov;38(11):E98. doi: 10.3174/ajnr.A5435. Epub 2017 Oct 19. AJNR Am J Neuroradiol. 2017. PMID: 29051206 Free PMC article. No abstract available.
  • Selective Poststent Balloon Angioplasty for Carotid Stenting.
    Pelz DM, Lownie SP. Pelz DM, et al. AJNR Am J Neuroradiol. 2017 Nov;38(11):E97. doi: 10.3174/ajnr.A5346. Epub 2017 Oct 19. AJNR Am J Neuroradiol. 2017. PMID: 29051210 Free PMC article. No abstract available.

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  • Reply.
    Petr O, Brinjikji W, Murad MH, Glodny B, Lanzino G. Petr O, et al. AJNR Am J Neuroradiol. 2017 Nov;38(11):E98. doi: 10.3174/ajnr.A5435. Epub 2017 Oct 19. AJNR Am J Neuroradiol. 2017. PMID: 29051206 Free PMC article. No abstract available.
  • Selective Poststent Balloon Angioplasty for Carotid Stenting.
    Pelz DM, Lownie SP. Pelz DM, et al. AJNR Am J Neuroradiol. 2017 Nov;38(11):E97. doi: 10.3174/ajnr.A5346. Epub 2017 Oct 19. AJNR Am J Neuroradiol. 2017. PMID: 29051210 Free PMC article. No abstract available.

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