https://scholars.lib.ntu.edu.tw/handle/123456789/590553
標題: | Carotid angioplasty with or without stenting versus carotid endarterectomy for carotid artery stenosis: A meta-analysis | 作者: | JIANN-SHING JENG HON-MAN LIU YONG-KWANG TU |
公開日期: | 2008 | 卷: | 270 | 期: | 44198 | 起(迄)頁: | 40-47 | 來源出版物: | Journal of the Neurological Sciences | 摘要: | Carotid angioplasty with or without stent placement (CAS) has emerged as an alternative to carotid endarterectomy (CEA) for revascularization of severe carotid artery stenosis in patients with high risk for surgery. This meta-analysis compared the efficacy and safety of both treatments from data for previous randomized trials. We did a literature search using Medline, PubMed, Cochrane database, and relevant articles for randomized trials comparing CAS with CEA. A meta-analysis using both random-effects and fixed-effects models compared outcome events of death, stroke, myocardial infarction, and cranial nerve injury at 30?days, 6?months, or 1?year after procedure. A total of nine trials involving 3138 patients (1564, CEA; 1574, CAS) with symptomatic or asymptomatic stenosis were included for analysis. By random-effects model, there was no significant difference of event rates between treatments for any stroke (odds ratio for CAS [95% confidence interval], 1.46 [0.91-2.36]), death or any stroke (1.37 [0.90-2.10]), or death, any stroke, or myocardial infarction (1.02 [0.49-2.11]) at 30-day, and death and any stroke at 6?months (1.50 [0.69-3.23]) or 1?year (1.25 [0.59-2.63]). But, there were significantly higher 30-day event rates after CAS than CEA for death or any stroke (1.37 [1.04-1.81]) by fix-effects model, accompanied with significant heterogeneity (p = 0.04). Risk of cranial nerve injury was much lower in CAS than in CEA (0.12 [0.05-0.29]). Except for lower risk of cranial nerve injury, CAS is neither safer nor associated with a better short-term outcome as compared to CEA in treating carotid artery stenosis. ? 2008 Elsevier B.V. All rights reserved. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-44649086431&doi=10.1016%2fj.jns.2008.01.012&partnerID=40&md5=462e520c7936dd78e41ff48395a8070c https://scholars.lib.ntu.edu.tw/handle/123456789/590553 |
ISSN: | 0022510X | DOI: | 10.1016/j.jns.2008.01.012 | SDG/關鍵字: | angioplasty; article; carotid angioplasty; carotid artery obstruction; carotid endarterectomy; clinical trial; Cochrane Library; confidence interval; cranial nerve injury; heart infarction; human; intermethod comparison; MEDLINE; meta analysis; mortality; outcome assessment; patient safety; postoperative complication; priority journal; randomization; revascularization; risk factor; stent; stroke; systematic review; Angioplasty; Carotid Stenosis; Endarterectomy, Carotid; Humans; PubMed; Randomized Controlled Trials as Topic; Statistics, Nonparametric; Stents |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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