Drug eluting stents versus bare metal stents for the treatment of extracranial vertebral artery disease: a meta-analysis

BackgroundWhile a growing number of reports offer evidence for the potential of drug eluting stents (DES) in treating atherosclerotic stenosis of the extracranial vertebral artery, their efficacy when compared with bare metal stents (BMS) is uncertain due to the lack of a large prospective randomized trial.MethodsA search strategy using the terms ‘stents’, ‘drug-eluting stents’, ‘atherosclerosis’, ‘vertebral artery’, and ‘vertebrobasilar insufficiency’ was employed through Medline. Five studies met the criteria for a comparative meta-analysis. The technical/clinical success, periprocedural complications, target vessel revascularization (TVR), rates of restenosis, recurrent symptoms, and overall survival were compared.ResultsThere was no significant difference in the technical success (OR=1.528, p=0.622), clinical success (OR=1.917, p=0.274), and periprocedural complications (OR=0.741, p=0.614) between the two groups. An OR of 0.388 for no restenosis in the BMS to DES arms (p=0.001) indicated a significantly higher restenosis rate in the BMS group relative to the DES group (33.57% vs 15.49%). When compared with the DES group, the BMS group had a significantly higher rate of recurrent symptoms (2.76% vs 11.26%; OR=3.319, p=0.011) and TVR (4.83% vs 19.21%; OR=4.099, p=0.001).ConclusionsA significantly lower rate of restenosis, recurrent symptoms, and TVR was noted in the DES group compared with the BMS group.

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Abstract WMP44: A Meta-Analysis of Drug Eluting Stents vs Bare Metal Stents for Treatment of Extracranial Vertebral Artery Disease

Stroke ◽

10.1161/str.44.suppl_1.awmp44 ◽

2013 ◽

Vol 44 (suppl_1) ◽

Author(s):

Nakul Sheth ◽

Vikas Gupta ◽

Wenzhuan He ◽

Shariyah Gordon ◽

Charles J Prestigiacomo ◽

...

Keyword(s):

Vertebral Artery ◽

Clinical Success ◽

Meta Analysis ◽

Bare Metal Stents ◽

Drug Eluting Stents ◽

Metal Stents ◽

Bare Metal ◽

Significant Difference ◽

Drug Eluting ◽

Extracranial Vertebral Artery

A Meta-Analysis of Drug Eluting Stents vs. Bare Metal Stents for Treatment of Extracranial Vertebral Artery Disease Background: —Although a growing number of reports offer evidence for the potential of drug eluting stents (DES) in treating atherosclerotic stenosis of the extracranial vertebral artery, their efficacy when compared to bare metal stents (BMS) is uncertain due to the lack of a large prospective randomized trial. Methods: —A search strategy was used using the terms "stents," "drug-eluting stents," "atherosclerosis," "vertebral artery," and "vertebrobasilar insufficiency" through Medline. Five studies met the criteria for a comparative meta-analysis. The technical and clinical success, periprocedural complications, target vessel revascularization (TVR), rates of restenosis and recurrent symptoms and overall survival were compared between the DES and BMS groups using the Mantel-Haenszel method with fixed and random effect models. Results: —The mean pretreatment stenosis was 83.8±4.2% in the DES group (n = 156) and 80.12±2.7% in the BMS group (n = 148). There was no significant difference in the technical success (OR = 1.528, p = 0.622), clinical success (OR = 1.917, p = 0.274) and periprocedural complications (OR = 0.741, p = 0.614) between the two groups. The rates of technical success, clinical success and periprocedural complications were 98.78%, 95.77% and 1.94% for the DES group vs. 100%, 97.96% and 2.96% for the BMS group. There was no periprocedural mortality, stroke or TIA. The mean clinical and radiological follow-up times were 19.1±6.9 and 14.23±1.5 months respectively, for the DES arm and 26±7.6 and 20.5±3.3 months, respectively, for the BMS group. A 0.388 odds ratio of no-restenosis in the BMS to DES arms (p = 0.001) indicated a significantly higher restenosis rate in the BMS group relative to the DES group (33.57% vs. 15.49%, respectively). When compared with the DES group, the BMS group had a significantly higher rate of recurrent symptoms (2.76% vs. 11.26%; OR = 3.319, p = 0.011) and TVR (4.83% vs. 19.21%; OR = 4.099, p = 0.001). There was no significant difference between overall survival (OR = 0.655, p = 0.32). Conclusion: —A lower rate of restenosis, recurrent symptoms and target vessel revascularization was noted in the DES group.

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DRUG ELUTING STENTS VERSUS BARE METAL STENTS IN SAPHENOUS VEIN GRAFT INTERVENTION: AN UPDATED META-ANALYSIS OF RANDOMIZED TRIALS

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(18)31917-x ◽

2018 ◽

Vol 71 (11) ◽

pp. A1376

Author(s):

Varunsiri Atti ◽

Nileshkumar J. Patel ◽

Chirag Bavishi ◽

Avnish Tripathi ◽

Nikhil Nalluri ◽

...

Keyword(s):

Saphenous Vein ◽

Randomized Trials ◽

Saphenous Vein Graft ◽

Meta Analysis ◽

Bare Metal Stents ◽

Drug Eluting Stents ◽

Metal Stents ◽

Bare Metal ◽

Drug Eluting ◽

Saphenous Vein Graft Intervention

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Comparison of drug-eluting and bare metal stents for extracranial vertebral artery stenting

Advances in Interventional Cardiology ◽

10.5114/aic.2019.87887 ◽

2019 ◽

Vol 15 (3) ◽

pp. 328-337

Author(s):

Damian Maciejewski ◽

Piotr Pieniazek ◽

Lukasz Tekieli ◽

Piotr Paluszek ◽

Tadeusz Przewlocki ◽

...

Keyword(s):

Vertebral Artery ◽

Bare Metal Stents ◽

Metal Stents ◽

Bare Metal ◽

Drug Eluting ◽

Extracranial Vertebral Artery ◽

Vertebral Artery Stenting

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Drug-Eluting Stents Versus Bare Metal Stents in Percutaneous Coronary Interventions (A Meta-Analysis)

The American Journal of Cardiology ◽

10.1016/j.amjcard.2005.01.040 ◽

2005 ◽

Vol 95 (10) ◽

pp. 1146-1152 ◽

Cited By ~ 64

Author(s):

Ciro Indolfi ◽

Maria Pavia ◽

Italo F. Angelillo

Keyword(s):

Meta Analysis ◽

Bare Metal Stents ◽

Drug Eluting Stents ◽

Metal Stents ◽

Percutaneous Coronary Interventions ◽

Bare Metal ◽

Coronary Interventions ◽

Percutaneous Coronary ◽

Drug Eluting

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Comparison by Meta-Analysis of Drug-Eluting Stents and Bare Metal Stents for Saphenous Vein Graft Intervention

The American Journal of Cardiology ◽

10.1016/j.amjcard.2009.12.006 ◽

2010 ◽

Vol 105 (8) ◽

pp. 1076-1082 ◽

Cited By ~ 41

Author(s):

Michael S. Lee ◽

Tae Yang ◽

David E. Kandzari ◽

Jonathan M. Tobis ◽

Hsini Liao ◽

...

Keyword(s):

Saphenous Vein ◽

Vein Graft ◽

Saphenous Vein Graft ◽

Meta Analysis ◽

Bare Metal Stents ◽

Drug Eluting Stents ◽

Metal Stents ◽

Bare Metal ◽

Drug Eluting ◽

Saphenous Vein Graft Intervention

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Meta-Analysis Comparison (Nine Trials) of Outcomes With Drug-Eluting Stents Versus Bare Metal Stents in Patients With Diabetes Mellitus

The American Journal of Cardiology ◽

10.1016/j.amjcard.2008.07.012 ◽

2008 ◽

Vol 102 (10) ◽

pp. 1328-1334 ◽

Cited By ~ 24

Author(s):

Giuseppe Patti ◽

Annunziata Nusca ◽

Germano Di Sciascio

Keyword(s):

Diabetes Mellitus ◽

Meta Analysis ◽

Bare Metal Stents ◽

Drug Eluting Stents ◽

Metal Stents ◽

Bare Metal ◽

Patients With Diabetes ◽

Drug Eluting

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Continuation of dual anti-platelet therapy after drug-eluting stents in primary angioplasty beyond 12 months

F1000Research ◽

10.12688/f1000research.1-53.v1 ◽

2012 ◽

Vol 1 ◽

pp. 53

Author(s):

Iman Mohasseb ◽

Christian A Gericke

Keyword(s):

Meta Analysis ◽

Bare Metal Stents ◽

Primary Angioplasty ◽

Drug Eluting Stents ◽

Metal Stents ◽

Clinical Implications ◽

Bare Metal ◽

Original Publication ◽

Anti Platelet Therapy ◽

Drug Eluting

In this correspondence we discuss the results of the meta-analysis by De Luca et al. (2012) in the Archives of Internal Medicine which found that late myocardial reinfarction and stent thrombosis is more common in drug-eluting stents than in bare-metal stents. We discuss the clinical implications of this paper for dual anti-platelet therapy which did not receive sufficient attention in the original publication and the accompanying editorial.

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