Balloon Dilatation and Stenting for Aortic Coarctation A Systematic Review and Meta-Analysis

被引:36
|
作者
Salcher, Maximilian [1 ]
Naci, Huseyin [1 ]
Law, Tyler J. [1 ,2 ]
Kuehne, Titus [3 ]
Schubert, Stephan [3 ]
Kelm, Marcus [3 ]
机构
[1] Univ London London Sch Econ & Polit Sci, LSE Hlth, London WC2A 2AE, England
[2] Univ Toronto, Dept Anesthesia, Toronto, ON, Canada
[3] Deutsch Herzzentrum Berlin, Dept Paediat Cardiol & Congenital Heart Dis, Berlin, Germany
关键词
aneurysm; angioplasty; balloon; congenital; meta-analysis; stent; TERM-FOLLOW-UP; NATIVE COARCTATION; RECURRENT COARCTATION; ANGIOPLASTY TREATMENT; ADULT; ADOLESCENTS; REPAIR; INCONSISTENCY; COMPLICATIONS; INTERMEDIATE;
D O I
10.1161/CIRCINTERVENTIONS.115.003153
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background-There is no systematic assessment of available evidence on effectiveness and comparative effectiveness of balloon dilatation and stenting for aortic coarctation. Methods and Results-We systematically searched 4 online databases to identify and select relevant studies of balloon dilatation and stenting for aortic coarctation based on a priori criteria (PROSPERO 2014:CRD42014014418). We quantitatively synthesized results for each intervention from single-arm studies and obtained pooled estimates for relative effectiveness from pairwise and network meta-analysis of comparative studies. Our primary analysis included 15 stenting (423 participants) and 12 balloon dilatation studies (361 participants), including patients >= 10 years of age. Post-treatment blood pressure gradient reduction to <= 20 and <= 10 mm Hg was achieved in 89.5% (95% confidence interval, 83.7-95.3) and 66.5% (44.1-88.9%) of patients undergoing balloon dilatation, and in 99.5% (97.5-100.0%) and 93.8% (88.5-99.1%) of patients undergoing stenting, respectively. Odds of achieving <= 20 mm Hg were lower with balloon dilatation as compared with stenting (odds ratio, 0.105 [0.010-0.886]). Thirty-day survival rates were comparable. Numerically more patients undergoing balloon dilatation experienced severe complications during admission (6.4% [2.6-10.2%]) compared with stenting (2.6% [0.5-4.7%]). This was supported by meta-analysis of head-to-head studies (odds ratio, 9.617 [2.654-34.845]) and network meta-analysis (odds ratio, 16.23, 95% credible interval: 4.27-62.77) in a secondary analysis in patients >= 1 month of age, including 57 stenting (3397 participants) and 62 balloon dilatation studies (4331 participants). Conclusions-Despite the limitations of the evidence base consisting predominantly of single-arm studies, our review indicates that stenting achieves superior immediate relief of a relevant pressure gradient compared with balloon dilatation.
引用
收藏
页数:89
相关论文
共 50 条
  • [1] A Systematic Review and Meta-analysis on Stenting for Aortic Coarctation Management in Adults
    Nana, Petroula
    Spanos, Konstantinos
    Brodis, Alexandros
    Kouvelos, George
    Rickers, Carsten
    Kozlik-Feldmann, Rainer
    Giannoukas, Athanasios
    Koelbel, Tilo
    JOURNAL OF ENDOVASCULAR THERAPY, 2023,
  • [2] Medium-term systemic blood pressure after stenting of aortic coarctation: a systematic review and meta-analysis
    Meijs, Timion A.
    Warmerdam, Evangeline G.
    Slieker, Martijn G.
    Krings, Gregor J.
    Molenschot, Mirella M. C.
    Meijboom, Folkert J.
    Sieswerda, Gertjan T.
    Doevendans, Pieter A.
    Bouma, Berto J.
    de Winter, Robbert J.
    Mulder, Barbara J. M.
    Voskuil, Michiel
    HEART, 2019, 105 (19) : 1464 - 1470
  • [3] LONG-TERM SYSTEMIC BLOOD PRESSURE AFTER ENDOVASCULAR STENTING OF AORTIC COARCTATION: A SYSTEMATIC REVIEW AND META-ANALYSIS
    Meijs, Timion
    Warmerdam, Evangeline
    Slieker, Martijn
    Krings, Gregor
    Molenschot, Mirella
    Meijboom, Folkert
    Sieswerda, Gertjan
    Doevendans, Pieter
    Bouma, Berto
    de Winter, Robbert
    Mulder, Barbara
    Voskuil, Michiel
    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2019, 73 (09) : 598 - 598
  • [4] A systematic review and meta-analysis of exercise and exercise hypertension in patients with aortic coarctation
    H J A Foulds
    N B Giacomantonio
    S S D Bredin
    D E R Warburton
    Journal of Human Hypertension, 2017, 31 : 768 - 775
  • [5] A systematic review and meta-analysis of exercise and exercise hypertension in patients with aortic coarctation
    Foulds, H. J. A.
    Giacomantonio, N. B.
    Bredin, S. S. D.
    Warburton, D. E. R.
    JOURNAL OF HUMAN HYPERTENSION, 2017, 31 (12) : 768 - 775
  • [6] Echocardiographic aortic root dilatation in hypertensive patients: a systematic review and meta-analysis
    Covella, Michele
    Milan, Alberto
    Totaro, Silvia
    Cuspidi, Cesare
    Re, Annalisa
    Rabbia, Franco
    Veglio, Franco
    JOURNAL OF HYPERTENSION, 2014, 32 (10) : 1928 - 1935
  • [8] Systematic review with meta-analysis: endoscopic balloon dilatation for Crohn's disease strictures
    Morar, P. S.
    Faiz, O.
    Warusavitarne, J.
    Brown, S.
    Cohen, R.
    Hind, D.
    Abercrombie, J.
    Ragunath, K.
    Sanders, D. S.
    Arnott, I.
    Wilson, G.
    Bloom, S.
    Arebi, N.
    ALIMENTARY PHARMACOLOGY & THERAPEUTICS, 2015, 42 (10) : 1137 - 1148
  • [9] ENDOSCOPIC BALLOON DILATATION FOR CROHN'S DISEASE STRICTURES: A SYSTEMATIC REVIEW AND META-ANALYSIS
    Morar, P.
    Faiz, O.
    Warusavitarne, J.
    Brown, S.
    Cohen, R.
    Hind, D.
    Abercrombie, J.
    Ragunath, K.
    Sanders, D. S.
    Arnott, I.
    Wilson, G.
    Bloom, S.
    GUT, 2015, 64 : A1 - A1
  • [10] Endoscopic Balloon Dilatation in the Treatment of Benign Ureteral Strictures: A Meta-Analysis and Systematic Review
    Lu, Chaoyue
    Zhang, Wei
    Peng, Yonghan
    Li, Ling
    Gao, Xiaomin
    Liu, Min
    Fang, Ziyu
    Wang, Zeyu
    Ming, Shaoxiong
    Dong, Hao
    Shen, Rong
    Xie, Fei
    Sun, Yinghao
    Gao, Xiaofeng
    JOURNAL OF ENDOUROLOGY, 2019, 33 (04) : 255 - 262