Endovascular Interventions for Femoropopliteal Peripheral Artery Disease: A Network Meta-Analysis of Current Technologies

被引:40
作者
Jaff, Michael R. [1 ]
Nelson, Teresa [2 ]
Ferko, Nicole [3 ]
Martinson, Melissa [2 ]
Anderson, Louise H. [2 ]
Hollmann, Sarah [3 ]
机构
[1] Newton Wellesley Hosp, Dept Med, 2014 Washington St, Newton, MA 02462 USA
[2] Techn Res LLC, Minneapolis, MN USA
[3] Cornerstone Res Grp, Burlington, ON, Canada
关键词
SUPERFICIAL FEMORAL-ARTERY; NITINOL STENT IMPLANTATION; PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY; PACLITAXEL-COATED BALLOON; RANDOMIZED CONTROLLED-TRIALS; BARE-METAL STENTS; ONE-YEAR OUTCOMES; PROXIMAL POPLITEAL; ELUTING STENTS; UNCOATED BALLOON;
D O I
10.1016/j.jvir.2017.08.003
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Purpose: To use network meta-analysis (NMA) to determine the optimal endovascular strategy for management of femoropopliteal peripheral artery disease (PAD) given the lack of multiple prospective randomized trials to guide treatment decisions. Materials and Methods: NMA is a new meta-analytic method that permits comparisons among any 2 therapies by combining results of a collection of clinical trials conducted in the same or similar patient population. NMA was used to analyze data from 15 randomized controlled trials (RCTs) and 10 prospective, multicenter, single-arm trials (combined evidence [CE] NMA) that evaluated target lesion revascularization (TLR) for 5 endovascular strategies: bare metal stent (BMS), polymer-covered metal stent (CMS), drug-eluting stent (DES), drug-coated balloon (DCB) and percutaneous transluminal angioplasty (PTA). Results: The RCT and CE NMAs included 2,912 (6,091) patients with 3,151 (6,786) person-years of follow-up. In the CE NMA, DCB provided a statistically significant 68% reduction in TLR compared with PTA and a statistically significant 53% reduction in TLR compared with BMS. BMS, CMS, and DES provided reductions in TLR of 33%, 48%, and 58% compared with PTA, with statistical significance achieved for CMS and DES. The significant reductions in TLR for DCB compared with PTA and BMS were replicated in the RCT NMA. Conclusions: This NMA demonstrated that DCB provided better reduction in TLR rates compared with PTA and BMS.
引用
收藏
页码:1617 / 1627
页数:11
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