Treatment of the Carotid In-stent Restenosis: A Systematic Review
Background and Purpose: In-stent restenosis (ISR) after carotid artery stent (CAS) is not uncommon. We aimed to evaluate therapeutic options for ISR after CAS. Methods: We searched PubMed and EMBASE until November 2, 2020 for studies including the treatment for ISR after CAS. Results: In total, 35 s...
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| Veröffentlicht in: | Frontiers in neurology 2021-10, Vol.12, p.748304-748304, Article 748304 |
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| container_title | Frontiers in neurology |
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| creator | Huang, Hao Wu, Lingshan Guo, Yinping Zhang, Yi Zhao, Jing Yu, Zhiyuan Luo, Xiang |
| description | Background and Purpose: In-stent restenosis (ISR) after carotid artery stent (CAS) is not uncommon. We aimed to evaluate therapeutic options for ISR after CAS.
Methods: We searched PubMed and EMBASE until November 2, 2020 for studies including the treatment for ISR after CAS.
Results: In total, 35 studies, covering 1,374 procedures in 1,359 patients, were included in this review. Most cases (66.3%) were treated with repeat CAS (rCAS), followed by percutaneous transluminal angioplasty (PTA) (17.5%), carotid endarterectomy (CEA) (14.3%), carotid artery bypass (1.5%), and external beam radiotherapy (0.4%). The rates of stroke & TIA within the postoperative period were similar in three groups (PTA 1.1%, rCAS 1.1%, CEA 1.5%). CEA (2.5%) was associated with a slightly higher rate of postoperative death than rCAS (0.7%, P = 0.046). Furthermore, the rate of long-term stroke & TIA in PTA was 5.7%, significantly higher than rCAS (1.8%, P = 0.036). PTA (27.8%) was also associated with a significantly higher recurrent restenosis rate than rCAS (8.2%, P = 0.002) and CEA (1.6%, P < 0.001). The long-term stroke & TIA and recurrent restenosis rates showed no significant difference between rCAS and CEA.
Conclusions: rCAS is the most common treatment for ISR, with low postoperative risk and low long-term risk. CEA is an important alternative for rCAS. PTA may be less recommended due to the relatively high long-term risks of stroke & TIA and recurrent restenosis. |
| doi_str_mv | 10.3389/fneur.2021.748304 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_crossref_primary_10_3389_fneur_2021_748304</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><doaj_id>oai_doaj_org_article_5650a5fb7025487d830cc4193e62bb68</doaj_id><sourcerecordid>2584430036</sourcerecordid><originalsourceid>FETCH-LOGICAL-c508t-fd0672a21cc54c9f3d9dc77a64f87e668b56b481e48c0040298288f51af906933</originalsourceid><addsrcrecordid>eNqNkctq3TAQhkVpaUKaB-jOy0Lxqe6XLgoHk7YHAoE0XQtZlhIF20olOSFvXzkOodlVm5Fm_vklzQfARwR3hEj1xc9uSTsMMdoJKgmkb8Ax4py2GCv29p_9ETjN-RbWRZQinLwHR4RygQiix2B_lZwpk5tLE31TblzTmRRLGJrD3Oay5i_dGmMO-Wuzb3491tNkSrC1cB_cwwfwzpsxu9PneAJ-fz-76n625xc_Dt3-vLUMytL6AXKBDUbWMmqVJ4MarBCGUy-F41z2jPdUIkelhZBCrCSW0jNkvIJcEXICDpvvEM2tvkthMulRRxP0UyKma21SfdboNOMMGuZ7ATGjUgx1OtZSpIjjuO-5rF7fNq-7pZ_cYOs3kxlfmb6uzOFGX8d7LRlGEONq8OnZIMU_Sx2QnkK2bhzN7OKSNWaSUlInzqsUbVKbYs7J-ZdrENQrSf1EUq8k9Uay9nzeeh5cH322wc3WvfRVkgIJjKlcoaKqlv-v7kKp8OLcxWUu5C-1yq_t</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2584430036</pqid></control><display><type>article</type><title>Treatment of the Carotid In-stent Restenosis: A Systematic Review</title><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central Open Access</source><source>Web of Science - Science Citation Index Expanded - 2021<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><source>PubMed Central</source><creator>Huang, Hao ; Wu, Lingshan ; Guo, Yinping ; Zhang, Yi ; Zhao, Jing ; Yu, Zhiyuan ; Luo, Xiang</creator><creatorcontrib>Huang, Hao ; Wu, Lingshan ; Guo, Yinping ; Zhang, Yi ; Zhao, Jing ; Yu, Zhiyuan ; Luo, Xiang</creatorcontrib><description>Background and Purpose: In-stent restenosis (ISR) after carotid artery stent (CAS) is not uncommon. We aimed to evaluate therapeutic options for ISR after CAS.
Methods: We searched PubMed and EMBASE until November 2, 2020 for studies including the treatment for ISR after CAS.
Results: In total, 35 studies, covering 1,374 procedures in 1,359 patients, were included in this review. Most cases (66.3%) were treated with repeat CAS (rCAS), followed by percutaneous transluminal angioplasty (PTA) (17.5%), carotid endarterectomy (CEA) (14.3%), carotid artery bypass (1.5%), and external beam radiotherapy (0.4%). The rates of stroke & TIA within the postoperative period were similar in three groups (PTA 1.1%, rCAS 1.1%, CEA 1.5%). CEA (2.5%) was associated with a slightly higher rate of postoperative death than rCAS (0.7%, P = 0.046). Furthermore, the rate of long-term stroke & TIA in PTA was 5.7%, significantly higher than rCAS (1.8%, P = 0.036). PTA (27.8%) was also associated with a significantly higher recurrent restenosis rate than rCAS (8.2%, P = 0.002) and CEA (1.6%, P < 0.001). The long-term stroke & TIA and recurrent restenosis rates showed no significant difference between rCAS and CEA.
Conclusions: rCAS is the most common treatment for ISR, with low postoperative risk and low long-term risk. CEA is an important alternative for rCAS. PTA may be less recommended due to the relatively high long-term risks of stroke & TIA and recurrent restenosis.</description><identifier>ISSN: 1664-2295</identifier><identifier>EISSN: 1664-2295</identifier><identifier>DOI: 10.3389/fneur.2021.748304</identifier><identifier>PMID: 34671314</identifier><language>eng</language><publisher>LAUSANNE: Frontiers Media Sa</publisher><subject>carotid artery stent (CAS) ; carotid endarterectomy (CEA) ; Clinical Neurology ; in-stent restenosis (ISR) ; Life Sciences & Biomedicine ; Neurology ; Neurosciences ; Neurosciences & Neurology ; percutaneous transluminal angioplasty (PTA) ; Science & Technology ; treatment</subject><ispartof>Frontiers in neurology, 2021-10, Vol.12, p.748304-748304, Article 748304</ispartof><rights>Copyright © 2021 Huang, Wu, Guo, Zhang, Zhao, Yu and Luo. 2021 Huang, Wu, Guo, Zhang, Zhao, Yu and Luo</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>13</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000717224800001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c508t-fd0672a21cc54c9f3d9dc77a64f87e668b56b481e48c0040298288f51af906933</citedby><cites>FETCH-LOGICAL-c508t-fd0672a21cc54c9f3d9dc77a64f87e668b56b481e48c0040298288f51af906933</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8521022/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8521022/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,729,782,786,866,887,2104,2116,27931,27932,39265,53798,53800</link.rule.ids></links><search><creatorcontrib>Huang, Hao</creatorcontrib><creatorcontrib>Wu, Lingshan</creatorcontrib><creatorcontrib>Guo, Yinping</creatorcontrib><creatorcontrib>Zhang, Yi</creatorcontrib><creatorcontrib>Zhao, Jing</creatorcontrib><creatorcontrib>Yu, Zhiyuan</creatorcontrib><creatorcontrib>Luo, Xiang</creatorcontrib><title>Treatment of the Carotid In-stent Restenosis: A Systematic Review</title><title>Frontiers in neurology</title><addtitle>FRONT NEUROL</addtitle><description>Background and Purpose: In-stent restenosis (ISR) after carotid artery stent (CAS) is not uncommon. We aimed to evaluate therapeutic options for ISR after CAS.
Methods: We searched PubMed and EMBASE until November 2, 2020 for studies including the treatment for ISR after CAS.
Results: In total, 35 studies, covering 1,374 procedures in 1,359 patients, were included in this review. Most cases (66.3%) were treated with repeat CAS (rCAS), followed by percutaneous transluminal angioplasty (PTA) (17.5%), carotid endarterectomy (CEA) (14.3%), carotid artery bypass (1.5%), and external beam radiotherapy (0.4%). The rates of stroke & TIA within the postoperative period were similar in three groups (PTA 1.1%, rCAS 1.1%, CEA 1.5%). CEA (2.5%) was associated with a slightly higher rate of postoperative death than rCAS (0.7%, P = 0.046). Furthermore, the rate of long-term stroke & TIA in PTA was 5.7%, significantly higher than rCAS (1.8%, P = 0.036). PTA (27.8%) was also associated with a significantly higher recurrent restenosis rate than rCAS (8.2%, P = 0.002) and CEA (1.6%, P < 0.001). The long-term stroke & TIA and recurrent restenosis rates showed no significant difference between rCAS and CEA.
Conclusions: rCAS is the most common treatment for ISR, with low postoperative risk and low long-term risk. CEA is an important alternative for rCAS. PTA may be less recommended due to the relatively high long-term risks of stroke & TIA and recurrent restenosis.</description><subject>carotid artery stent (CAS)</subject><subject>carotid endarterectomy (CEA)</subject><subject>Clinical Neurology</subject><subject>in-stent restenosis (ISR)</subject><subject>Life Sciences & Biomedicine</subject><subject>Neurology</subject><subject>Neurosciences</subject><subject>Neurosciences & Neurology</subject><subject>percutaneous transluminal angioplasty (PTA)</subject><subject>Science & Technology</subject><subject>treatment</subject><issn>1664-2295</issn><issn>1664-2295</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>HGBXW</sourceid><sourceid>DOA</sourceid><recordid>eNqNkctq3TAQhkVpaUKaB-jOy0Lxqe6XLgoHk7YHAoE0XQtZlhIF20olOSFvXzkOodlVm5Fm_vklzQfARwR3hEj1xc9uSTsMMdoJKgmkb8Ax4py2GCv29p_9ETjN-RbWRZQinLwHR4RygQiix2B_lZwpk5tLE31TblzTmRRLGJrD3Oay5i_dGmMO-Wuzb3491tNkSrC1cB_cwwfwzpsxu9PneAJ-fz-76n625xc_Dt3-vLUMytL6AXKBDUbWMmqVJ4MarBCGUy-F41z2jPdUIkelhZBCrCSW0jNkvIJcEXICDpvvEM2tvkthMulRRxP0UyKma21SfdboNOMMGuZ7ATGjUgx1OtZSpIjjuO-5rF7fNq-7pZ_cYOs3kxlfmb6uzOFGX8d7LRlGEONq8OnZIMU_Sx2QnkK2bhzN7OKSNWaSUlInzqsUbVKbYs7J-ZdrENQrSf1EUq8k9Uay9nzeeh5cH322wc3WvfRVkgIJjKlcoaKqlv-v7kKp8OLcxWUu5C-1yq_t</recordid><startdate>20211004</startdate><enddate>20211004</enddate><creator>Huang, Hao</creator><creator>Wu, Lingshan</creator><creator>Guo, Yinping</creator><creator>Zhang, Yi</creator><creator>Zhao, Jing</creator><creator>Yu, Zhiyuan</creator><creator>Luo, Xiang</creator><general>Frontiers Media Sa</general><general>Frontiers Media S.A</general><scope>BLEPL</scope><scope>DTL</scope><scope>HGBXW</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20211004</creationdate><title>Treatment of the Carotid In-stent Restenosis: A Systematic Review</title><author>Huang, Hao ; Wu, Lingshan ; Guo, Yinping ; Zhang, Yi ; Zhao, Jing ; Yu, Zhiyuan ; Luo, Xiang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c508t-fd0672a21cc54c9f3d9dc77a64f87e668b56b481e48c0040298288f51af906933</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>carotid artery stent (CAS)</topic><topic>carotid endarterectomy (CEA)</topic><topic>Clinical Neurology</topic><topic>in-stent restenosis (ISR)</topic><topic>Life Sciences & Biomedicine</topic><topic>Neurology</topic><topic>Neurosciences</topic><topic>Neurosciences & Neurology</topic><topic>percutaneous transluminal angioplasty (PTA)</topic><topic>Science & Technology</topic><topic>treatment</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Huang, Hao</creatorcontrib><creatorcontrib>Wu, Lingshan</creatorcontrib><creatorcontrib>Guo, Yinping</creatorcontrib><creatorcontrib>Zhang, Yi</creatorcontrib><creatorcontrib>Zhao, Jing</creatorcontrib><creatorcontrib>Yu, Zhiyuan</creatorcontrib><creatorcontrib>Luo, Xiang</creatorcontrib><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Web of Science - Science Citation Index Expanded - 2021</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Frontiers in neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Huang, Hao</au><au>Wu, Lingshan</au><au>Guo, Yinping</au><au>Zhang, Yi</au><au>Zhao, Jing</au><au>Yu, Zhiyuan</au><au>Luo, Xiang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treatment of the Carotid In-stent Restenosis: A Systematic Review</atitle><jtitle>Frontiers in neurology</jtitle><stitle>FRONT NEUROL</stitle><date>2021-10-04</date><risdate>2021</risdate><volume>12</volume><spage>748304</spage><epage>748304</epage><pages>748304-748304</pages><artnum>748304</artnum><issn>1664-2295</issn><eissn>1664-2295</eissn><abstract>Background and Purpose: In-stent restenosis (ISR) after carotid artery stent (CAS) is not uncommon. We aimed to evaluate therapeutic options for ISR after CAS.
Methods: We searched PubMed and EMBASE until November 2, 2020 for studies including the treatment for ISR after CAS.
Results: In total, 35 studies, covering 1,374 procedures in 1,359 patients, were included in this review. Most cases (66.3%) were treated with repeat CAS (rCAS), followed by percutaneous transluminal angioplasty (PTA) (17.5%), carotid endarterectomy (CEA) (14.3%), carotid artery bypass (1.5%), and external beam radiotherapy (0.4%). The rates of stroke & TIA within the postoperative period were similar in three groups (PTA 1.1%, rCAS 1.1%, CEA 1.5%). CEA (2.5%) was associated with a slightly higher rate of postoperative death than rCAS (0.7%, P = 0.046). Furthermore, the rate of long-term stroke & TIA in PTA was 5.7%, significantly higher than rCAS (1.8%, P = 0.036). PTA (27.8%) was also associated with a significantly higher recurrent restenosis rate than rCAS (8.2%, P = 0.002) and CEA (1.6%, P < 0.001). The long-term stroke & TIA and recurrent restenosis rates showed no significant difference between rCAS and CEA.
Conclusions: rCAS is the most common treatment for ISR, with low postoperative risk and low long-term risk. CEA is an important alternative for rCAS. PTA may be less recommended due to the relatively high long-term risks of stroke & TIA and recurrent restenosis.</abstract><cop>LAUSANNE</cop><pub>Frontiers Media Sa</pub><pmid>34671314</pmid><doi>10.3389/fneur.2021.748304</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | carotid artery stent (CAS) carotid endarterectomy (CEA) Clinical Neurology in-stent restenosis (ISR) Life Sciences & Biomedicine Neurology Neurosciences Neurosciences & Neurology percutaneous transluminal angioplasty (PTA) Science & Technology treatment |
| title | Treatment of the Carotid In-stent Restenosis: A Systematic Review |
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