Infragenicular Stent Implantation for Below-the-Knee Atherosclerotic Disease: Clinical Evidence from an International Collaborative Meta-Analysis on 640 Patients
Purpose: To report a systematic review of the literature published on the outcomes of stenting for below-the-knee disease in patients with critical limb ischemia (CLI). Methods: Potentially relevant studies of stent implantation in the infragenicular arteries in ≥5 patients with ≥1-month follow-up w...
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| Veröffentlicht in: | Journal of Endovascular Therapy 2009-06, Vol.16 (3), p.251-263 |
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| creator | Biondi-Zoccai, Giuseppe G.L. Sangiorgi, Giuseppe Lotrionte, Marzia Feiring, Andrew Commeau, Philippe Fusaro, Massimiliano Agostoni, Pierfrancesco Bosiers, Marc Peregrin, Jan Rosales, Oscar Cotroneo, Antonio R. Rand, Thomas Sheiban, Imad |
| description | Purpose:
To report a systematic review of the literature published on the outcomes of
stenting for below-the-knee disease in patients with critical limb ischemia
(CLI).
Methods:
Potentially relevant studies of stent implantation in the infragenicular
arteries in ≥5 patients with ≥1-month follow-up were
systematically sought in BioMedCentral, ClinicalTrials.gov, The Cochrane
Collaboration Register of Controlled Trials (CENTRAL), Google Scholar, and
PubMed. Data were abstracted and pooled with a random-effect model to
generate risk estimates with 95% confidence intervals (CI).
Interaction tests were performed to compare different stent types. A risk of
bias assessment was conducted separately, as were appraisals for small study
bias, statistical heterogeneity, and inconsistency.
Results:
Eighteen nonrandomized studies were retrieved comprising 640 patients. After
a median follow-up of 12 months, binary in-stent restenosis occurred in
25.7% (95% CI 11.6% to 40.0%), primary patency
in 78.9% (95% CI 71.8% to 86.0%), improvement in
Rutherford class in 91.3% (95% CI 85.5% to
97.1%), target vessel revascularization in 10.1% (95%
CI 6.2% to 13.9%), and limb salvage in 96.4%
(95% CI 94.7% to 98.1%). Head-to-head comparisons
showed that sirolimus-eluting stents were superior to balloon-expandable
bare metal stents in preventing restenosis and increasing primary patency
(both p |
| doi_str_mv | 10.1583/09-2691.1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_67541029</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1583_09-2691.1</sage_id><sourcerecordid>67541029</sourcerecordid><originalsourceid>FETCH-LOGICAL-c407t-aa16a656fe9aa6505b7d00adcf338b8d0ee48ccd1bbb33d1e7ed6cccee4a63163</originalsourceid><addsrcrecordid>eNplUV1PFDEUbYhEEH3wD5jGBxMfCu18dGZ8W1fEDRhIlOem07kDJZ12aTsYfo7_1LuwySb40vt1cu7pPYS8F_xY1G15wjtWyE4ciz1yKOqqZqKu-atNXkgmedEekDcp3XFeiEKI1-RAdLIqmrY7JH9Xfoz6Brw1s9OR_srgM11Na6d91tkGT8cQ6Vdw4Q_Lt8DOPQBdYBZDMg7fbA39ZhPoBF_o0llk0o6ePtgBvAE6xjBR7enKZ4j-iRHHy-Cc7kPE-gHoT8iaLbD_mGyiuFJWnF7hDLWkt2R_1C7Bu208ItffT38vf7CLy7PVcnHBTMWbzLQWUstajtBpjLzum4FzPZixLNu-HThA1RoziL7vy3IQ0MAgjTHY1rIUsjwin5551zHcz5CymmwygDo9hDkp2dSV4EWHwI8vgHdhxq-5pPC6vCt41SLo8zPI4J1ShFGto510fFSCq41pindqY5oSiP2wJZz7CYYdcuvSTlpCp3bb_mf6B7tXoII</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>211092048</pqid></control><display><type>article</type><title>Infragenicular Stent Implantation for Below-the-Knee Atherosclerotic Disease: Clinical Evidence from an International Collaborative Meta-Analysis on 640 Patients</title><source>SAGE Complete A-Z List</source><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Biondi-Zoccai, Giuseppe G.L. ; Sangiorgi, Giuseppe ; Lotrionte, Marzia ; Feiring, Andrew ; Commeau, Philippe ; Fusaro, Massimiliano ; Agostoni, Pierfrancesco ; Bosiers, Marc ; Peregrin, Jan ; Rosales, Oscar ; Cotroneo, Antonio R. ; Rand, Thomas ; Sheiban, Imad</creator><creatorcontrib>Biondi-Zoccai, Giuseppe G.L. ; Sangiorgi, Giuseppe ; Lotrionte, Marzia ; Feiring, Andrew ; Commeau, Philippe ; Fusaro, Massimiliano ; Agostoni, Pierfrancesco ; Bosiers, Marc ; Peregrin, Jan ; Rosales, Oscar ; Cotroneo, Antonio R. ; Rand, Thomas ; Sheiban, Imad</creatorcontrib><description>Purpose:
To report a systematic review of the literature published on the outcomes of
stenting for below-the-knee disease in patients with critical limb ischemia
(CLI).
Methods:
Potentially relevant studies of stent implantation in the infragenicular
arteries in ≥5 patients with ≥1-month follow-up were
systematically sought in BioMedCentral, ClinicalTrials.gov, The Cochrane
Collaboration Register of Controlled Trials (CENTRAL), Google Scholar, and
PubMed. Data were abstracted and pooled with a random-effect model to
generate risk estimates with 95% confidence intervals (CI).
Interaction tests were performed to compare different stent types. A risk of
bias assessment was conducted separately, as were appraisals for small study
bias, statistical heterogeneity, and inconsistency.
Results:
Eighteen nonrandomized studies were retrieved comprising 640 patients. After
a median follow-up of 12 months, binary in-stent restenosis occurred in
25.7% (95% CI 11.6% to 40.0%), primary patency
in 78.9% (95% CI 71.8% to 86.0%), improvement in
Rutherford class in 91.3% (95% CI 85.5% to
97.1%), target vessel revascularization in 10.1% (95%
CI 6.2% to 13.9%), and limb salvage in 96.4%
(95% CI 94.7% to 98.1%). Head-to-head comparisons
showed that sirolimus-eluting stents were superior to balloon-expandable
bare metal stents in preventing restenosis and increasing primary patency
(both p<0.001); sirolimus-eluting stents were also better than
paclitaxel-eluting stents in terms of primary patency (p<0.001) and
repeat revascularizations (p=0.014).
Conclusion:
Percutaneous infragenicular stent implantation after failed or unsuccessful
balloon angioplasty is associated with favorable clinical results in
patients with CLI. Notwithstanding limitations of primary studies,
sirolimus-eluting stents appear superior to bare metal and
paclitaxel-eluting stents in terms of angiographic and/or clinical
outcomes.</description><identifier>ISSN: 1526-6028</identifier><identifier>EISSN: 1545-1550</identifier><identifier>DOI: 10.1583/09-2691.1</identifier><identifier>PMID: 19642789</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Angioplasty ; Atherosclerosis - therapy ; Confidence intervals ; Equipment Design ; Heart surgery ; Humans ; Hypothesis testing ; Industrialized nations ; Leg - blood supply ; Meta-analysis ; Patient care planning ; Peripheral Vascular Diseases - therapy ; Risk ; Sample size ; Standard deviation ; Statistical methods ; Stents ; Studies</subject><ispartof>Journal of Endovascular Therapy, 2009-06, Vol.16 (3), p.251-263</ispartof><rights>2009 International Society of Endovascular Specialists</rights><rights>Copyright Allen Press Publishing Services Jun 2009</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c407t-aa16a656fe9aa6505b7d00adcf338b8d0ee48ccd1bbb33d1e7ed6cccee4a63163</citedby><cites>FETCH-LOGICAL-c407t-aa16a656fe9aa6505b7d00adcf338b8d0ee48ccd1bbb33d1e7ed6cccee4a63163</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1583/09-2691.1$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1583/09-2691.1$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>313,314,776,780,788,21798,27899,27901,27902,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19642789$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Biondi-Zoccai, Giuseppe G.L.</creatorcontrib><creatorcontrib>Sangiorgi, Giuseppe</creatorcontrib><creatorcontrib>Lotrionte, Marzia</creatorcontrib><creatorcontrib>Feiring, Andrew</creatorcontrib><creatorcontrib>Commeau, Philippe</creatorcontrib><creatorcontrib>Fusaro, Massimiliano</creatorcontrib><creatorcontrib>Agostoni, Pierfrancesco</creatorcontrib><creatorcontrib>Bosiers, Marc</creatorcontrib><creatorcontrib>Peregrin, Jan</creatorcontrib><creatorcontrib>Rosales, Oscar</creatorcontrib><creatorcontrib>Cotroneo, Antonio R.</creatorcontrib><creatorcontrib>Rand, Thomas</creatorcontrib><creatorcontrib>Sheiban, Imad</creatorcontrib><title>Infragenicular Stent Implantation for Below-the-Knee Atherosclerotic Disease: Clinical Evidence from an International Collaborative Meta-Analysis on 640 Patients</title><title>Journal of Endovascular Therapy</title><addtitle>J Endovasc Ther</addtitle><description>Purpose:
To report a systematic review of the literature published on the outcomes of
stenting for below-the-knee disease in patients with critical limb ischemia
(CLI).
Methods:
Potentially relevant studies of stent implantation in the infragenicular
arteries in ≥5 patients with ≥1-month follow-up were
systematically sought in BioMedCentral, ClinicalTrials.gov, The Cochrane
Collaboration Register of Controlled Trials (CENTRAL), Google Scholar, and
PubMed. Data were abstracted and pooled with a random-effect model to
generate risk estimates with 95% confidence intervals (CI).
Interaction tests were performed to compare different stent types. A risk of
bias assessment was conducted separately, as were appraisals for small study
bias, statistical heterogeneity, and inconsistency.
Results:
Eighteen nonrandomized studies were retrieved comprising 640 patients. After
a median follow-up of 12 months, binary in-stent restenosis occurred in
25.7% (95% CI 11.6% to 40.0%), primary patency
in 78.9% (95% CI 71.8% to 86.0%), improvement in
Rutherford class in 91.3% (95% CI 85.5% to
97.1%), target vessel revascularization in 10.1% (95%
CI 6.2% to 13.9%), and limb salvage in 96.4%
(95% CI 94.7% to 98.1%). Head-to-head comparisons
showed that sirolimus-eluting stents were superior to balloon-expandable
bare metal stents in preventing restenosis and increasing primary patency
(both p<0.001); sirolimus-eluting stents were also better than
paclitaxel-eluting stents in terms of primary patency (p<0.001) and
repeat revascularizations (p=0.014).
Conclusion:
Percutaneous infragenicular stent implantation after failed or unsuccessful
balloon angioplasty is associated with favorable clinical results in
patients with CLI. Notwithstanding limitations of primary studies,
sirolimus-eluting stents appear superior to bare metal and
paclitaxel-eluting stents in terms of angiographic and/or clinical
outcomes.</description><subject>Angioplasty</subject><subject>Atherosclerosis - therapy</subject><subject>Confidence intervals</subject><subject>Equipment Design</subject><subject>Heart surgery</subject><subject>Humans</subject><subject>Hypothesis testing</subject><subject>Industrialized nations</subject><subject>Leg - blood supply</subject><subject>Meta-analysis</subject><subject>Patient care planning</subject><subject>Peripheral Vascular Diseases - therapy</subject><subject>Risk</subject><subject>Sample size</subject><subject>Standard deviation</subject><subject>Statistical methods</subject><subject>Stents</subject><subject>Studies</subject><issn>1526-6028</issn><issn>1545-1550</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNplUV1PFDEUbYhEEH3wD5jGBxMfCu18dGZ8W1fEDRhIlOem07kDJZ12aTsYfo7_1LuwySb40vt1cu7pPYS8F_xY1G15wjtWyE4ciz1yKOqqZqKu-atNXkgmedEekDcp3XFeiEKI1-RAdLIqmrY7JH9Xfoz6Brw1s9OR_srgM11Na6d91tkGT8cQ6Vdw4Q_Lt8DOPQBdYBZDMg7fbA39ZhPoBF_o0llk0o6ePtgBvAE6xjBR7enKZ4j-iRHHy-Cc7kPE-gHoT8iaLbD_mGyiuFJWnF7hDLWkt2R_1C7Bu208ItffT38vf7CLy7PVcnHBTMWbzLQWUstajtBpjLzum4FzPZixLNu-HThA1RoziL7vy3IQ0MAgjTHY1rIUsjwin5551zHcz5CymmwygDo9hDkp2dSV4EWHwI8vgHdhxq-5pPC6vCt41SLo8zPI4J1ShFGto510fFSCq41pindqY5oSiP2wJZz7CYYdcuvSTlpCp3bb_mf6B7tXoII</recordid><startdate>200906</startdate><enddate>200906</enddate><creator>Biondi-Zoccai, Giuseppe G.L.</creator><creator>Sangiorgi, Giuseppe</creator><creator>Lotrionte, Marzia</creator><creator>Feiring, Andrew</creator><creator>Commeau, Philippe</creator><creator>Fusaro, Massimiliano</creator><creator>Agostoni, Pierfrancesco</creator><creator>Bosiers, Marc</creator><creator>Peregrin, Jan</creator><creator>Rosales, Oscar</creator><creator>Cotroneo, Antonio R.</creator><creator>Rand, Thomas</creator><creator>Sheiban, Imad</creator><general>SAGE Publications</general><general>Allen Press Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>200906</creationdate><title>Infragenicular Stent Implantation for Below-the-Knee Atherosclerotic Disease: Clinical Evidence from an International Collaborative Meta-Analysis on 640 Patients</title><author>Biondi-Zoccai, Giuseppe G.L. ; Sangiorgi, Giuseppe ; Lotrionte, Marzia ; Feiring, Andrew ; Commeau, Philippe ; Fusaro, Massimiliano ; Agostoni, Pierfrancesco ; Bosiers, Marc ; Peregrin, Jan ; Rosales, Oscar ; Cotroneo, Antonio R. ; Rand, Thomas ; Sheiban, Imad</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c407t-aa16a656fe9aa6505b7d00adcf338b8d0ee48ccd1bbb33d1e7ed6cccee4a63163</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Angioplasty</topic><topic>Atherosclerosis - therapy</topic><topic>Confidence intervals</topic><topic>Equipment Design</topic><topic>Heart surgery</topic><topic>Humans</topic><topic>Hypothesis testing</topic><topic>Industrialized nations</topic><topic>Leg - blood supply</topic><topic>Meta-analysis</topic><topic>Patient care planning</topic><topic>Peripheral Vascular Diseases - therapy</topic><topic>Risk</topic><topic>Sample size</topic><topic>Standard deviation</topic><topic>Statistical methods</topic><topic>Stents</topic><topic>Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Biondi-Zoccai, Giuseppe G.L.</creatorcontrib><creatorcontrib>Sangiorgi, Giuseppe</creatorcontrib><creatorcontrib>Lotrionte, Marzia</creatorcontrib><creatorcontrib>Feiring, Andrew</creatorcontrib><creatorcontrib>Commeau, Philippe</creatorcontrib><creatorcontrib>Fusaro, Massimiliano</creatorcontrib><creatorcontrib>Agostoni, Pierfrancesco</creatorcontrib><creatorcontrib>Bosiers, Marc</creatorcontrib><creatorcontrib>Peregrin, Jan</creatorcontrib><creatorcontrib>Rosales, Oscar</creatorcontrib><creatorcontrib>Cotroneo, Antonio R.</creatorcontrib><creatorcontrib>Rand, Thomas</creatorcontrib><creatorcontrib>Sheiban, Imad</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of Endovascular Therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Biondi-Zoccai, Giuseppe G.L.</au><au>Sangiorgi, Giuseppe</au><au>Lotrionte, Marzia</au><au>Feiring, Andrew</au><au>Commeau, Philippe</au><au>Fusaro, Massimiliano</au><au>Agostoni, Pierfrancesco</au><au>Bosiers, Marc</au><au>Peregrin, Jan</au><au>Rosales, Oscar</au><au>Cotroneo, Antonio R.</au><au>Rand, Thomas</au><au>Sheiban, Imad</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Infragenicular Stent Implantation for Below-the-Knee Atherosclerotic Disease: Clinical Evidence from an International Collaborative Meta-Analysis on 640 Patients</atitle><jtitle>Journal of Endovascular Therapy</jtitle><addtitle>J Endovasc Ther</addtitle><date>2009-06</date><risdate>2009</risdate><volume>16</volume><issue>3</issue><spage>251</spage><epage>263</epage><pages>251-263</pages><issn>1526-6028</issn><eissn>1545-1550</eissn><abstract>Purpose:
To report a systematic review of the literature published on the outcomes of
stenting for below-the-knee disease in patients with critical limb ischemia
(CLI).
Methods:
Potentially relevant studies of stent implantation in the infragenicular
arteries in ≥5 patients with ≥1-month follow-up were
systematically sought in BioMedCentral, ClinicalTrials.gov, The Cochrane
Collaboration Register of Controlled Trials (CENTRAL), Google Scholar, and
PubMed. Data were abstracted and pooled with a random-effect model to
generate risk estimates with 95% confidence intervals (CI).
Interaction tests were performed to compare different stent types. A risk of
bias assessment was conducted separately, as were appraisals for small study
bias, statistical heterogeneity, and inconsistency.
Results:
Eighteen nonrandomized studies were retrieved comprising 640 patients. After
a median follow-up of 12 months, binary in-stent restenosis occurred in
25.7% (95% CI 11.6% to 40.0%), primary patency
in 78.9% (95% CI 71.8% to 86.0%), improvement in
Rutherford class in 91.3% (95% CI 85.5% to
97.1%), target vessel revascularization in 10.1% (95%
CI 6.2% to 13.9%), and limb salvage in 96.4%
(95% CI 94.7% to 98.1%). Head-to-head comparisons
showed that sirolimus-eluting stents were superior to balloon-expandable
bare metal stents in preventing restenosis and increasing primary patency
(both p<0.001); sirolimus-eluting stents were also better than
paclitaxel-eluting stents in terms of primary patency (p<0.001) and
repeat revascularizations (p=0.014).
Conclusion:
Percutaneous infragenicular stent implantation after failed or unsuccessful
balloon angioplasty is associated with favorable clinical results in
patients with CLI. Notwithstanding limitations of primary studies,
sirolimus-eluting stents appear superior to bare metal and
paclitaxel-eluting stents in terms of angiographic and/or clinical
outcomes.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>19642789</pmid><doi>10.1583/09-2691.1</doi><tpages>13</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1526-6028 |
| ispartof | Journal of Endovascular Therapy, 2009-06, Vol.16 (3), p.251-263 |
| issn | 1526-6028 1545-1550 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_67541029 |
| source | SAGE Complete A-Z List; MEDLINE; Alma/SFX Local Collection |
| subjects | Angioplasty Atherosclerosis - therapy Confidence intervals Equipment Design Heart surgery Humans Hypothesis testing Industrialized nations Leg - blood supply Meta-analysis Patient care planning Peripheral Vascular Diseases - therapy Risk Sample size Standard deviation Statistical methods Stents Studies |
| title | Infragenicular Stent Implantation for Below-the-Knee Atherosclerotic Disease: Clinical Evidence from an International Collaborative Meta-Analysis on 640 Patients |
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