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Clinical outcomes of second- versus first-generation carotid stents : a systematic review and meta-analysis
carotid artery stenting
systematic review and meta-analysis
stent design
“mesh-covered” dual-layer stents
stroke prevention
Background: Single-cohort studies suggest that second-generation stents (SGS; “mesh stents”) may improve carotid artery stenting (CAS) outcomes by limiting peri- and postprocedural cerebral embolism. SGS differ in the stent frame construction, mesh material, and design, as well as in mesh-to-frame position (inside/outside). Objectives: To compare clinical outcomes of SGS in relation to first-generation stents (FGSs; single-layer) in CAS. Methods: We performed a systematic review and meta-analysis of clinical studies with FGSs and SGS (PRISMA methodology, 3302 records). Endpoints were 30-day death, stroke, myocardial infarction (DSM), and 12-month ipsilateral stroke (IS) and restenosis (ISR). A random-effect model was applied. Results: Data of 68,422 patients from 112 eligible studies (68.2% men, 44.9% symptomatic) were meta-analyzed. Thirty-day DSM was 1.30% vs. 4.11% (p < 0.01, data for SGS vs. FGS). Among SGS, both Casper/Roadsaver and CGuard reduced 30-day DSM (by 2.78 and 3.03 absolute percent, p = 0.02 and p < 0.001), whereas the Gore stent was neutral. SGSs significantly improved outcomes compared with closed-cell FGS (30-day stroke 0.6% vs. 2.32%, p = 0.014; DSM 1.3% vs. 3.15%, p < 0.01). At 12 months, in relation to FGS, Casper/Roadsaver reduced IS (−3.25%, p < 0.05) but increased ISR (+3.19%, p = 0.04), CGuard showed a reduction in both IS and ISR (−3.13%, −3.63%; p = 0.01, p < 0.01), whereas the Gore stent was neutral. Conclusions: Pooled SGS use was associated with improved short- and long-term clinical results of CAS. Individual SGS types, however, differed significantly in their outcomes, indicating a lack of a “mesh stent” class effect. Findings from this meta-analysis may provide clinically relevant information in anticipation of large-scale randomized trials.
cris.lastimport.wos | 2024-04-09T18:28:26Z | |
dc.abstract.en | Background: Single-cohort studies suggest that second-generation stents (SGS; “mesh stents”) may improve carotid artery stenting (CAS) outcomes by limiting peri- and postprocedural cerebral embolism. SGS differ in the stent frame construction, mesh material, and design, as well as in mesh-to-frame position (inside/outside). Objectives: To compare clinical outcomes of SGS in relation to first-generation stents (FGSs; single-layer) in CAS. Methods: We performed a systematic review and meta-analysis of clinical studies with FGSs and SGS (PRISMA methodology, 3302 records). Endpoints were 30-day death, stroke, myocardial infarction (DSM), and 12-month ipsilateral stroke (IS) and restenosis (ISR). A random-effect model was applied. Results: Data of 68,422 patients from 112 eligible studies (68.2% men, 44.9% symptomatic) were meta-analyzed. Thirty-day DSM was 1.30% vs. 4.11% (p < 0.01, data for SGS vs. FGS). Among SGS, both Casper/Roadsaver and CGuard reduced 30-day DSM (by 2.78 and 3.03 absolute percent, p = 0.02 and p < 0.001), whereas the Gore stent was neutral. SGSs significantly improved outcomes compared with closed-cell FGS (30-day stroke 0.6% vs. 2.32%, p = 0.014; DSM 1.3% vs. 3.15%, p < 0.01). At 12 months, in relation to FGS, Casper/Roadsaver reduced IS (−3.25%, p < 0.05) but increased ISR (+3.19%, p = 0.04), CGuard showed a reduction in both IS and ISR (−3.13%, −3.63%; p = 0.01, p < 0.01), whereas the Gore stent was neutral. Conclusions: Pooled SGS use was associated with improved short- and long-term clinical results of CAS. Individual SGS types, however, differed significantly in their outcomes, indicating a lack of a “mesh stent” class effect. Findings from this meta-analysis may provide clinically relevant information in anticipation of large-scale randomized trials. | |
dc.affiliation | Wydział Lekarski : Zakład Bioinformatyki i Telemedycyny | pl |
dc.affiliation | Wydział Lekarski : Instytut Kardiologii | pl |
dc.cm.date | 2022-09-21T22:17:07Z | |
dc.cm.id | 109665 | pl |
dc.cm.idOmega | UJCM09ccab8ef3c54d438248ae93a495d8e9 | pl |
dc.contributor.author | Mazurek, Adam - 141450 | pl |
dc.contributor.author | Malinowski, Krzysztof - 223544 | pl |
dc.contributor.author | Rosenfield, Kenneth | pl |
dc.contributor.author | Capoccia, Laura | pl |
dc.contributor.author | Speziale, Francesco | pl |
dc.contributor.author | de Donato, Gianmarco | pl |
dc.contributor.author | Setacci, Carlo | pl |
dc.contributor.author | Wissgott, Christian | pl |
dc.contributor.author | Sirignano, Pasqualino | pl |
dc.contributor.author | Tekieli, Lukasz | pl |
dc.contributor.author | Karpenko, Andrey | pl |
dc.contributor.author | Kuczmik, Waclaw | pl |
dc.contributor.author | Stabile, Eugenio | pl |
dc.contributor.author | Metzger, David Christopher | pl |
dc.contributor.author | Amor, Max | pl |
dc.contributor.author | Siddiqui, Adnan H. | pl |
dc.contributor.author | Micari, Antonio | pl |
dc.contributor.author | Odrowąż-Pieniążek, Piotr - 133022 | pl |
dc.contributor.author | Cremonesi, Alberto | pl |
dc.contributor.author | Schofer, Joachim | pl |
dc.contributor.author | Schmidt, Andrej | pl |
dc.contributor.author | Musiałek, Piotr - 173944 | pl |
dc.date.accession | 2022-09-21 | pl |
dc.date.accessioned | 2022-09-21T22:17:07Z | |
dc.date.available | 2022-09-21T22:17:07Z | |
dc.date.issued | 2022 | pl |
dc.date.openaccess | 0 | |
dc.description.accesstime | w momencie opublikowania | |
dc.description.number | 16 | pl |
dc.description.version | ostateczna wersja wydawcy | |
dc.description.volume | 11 | pl |
dc.identifier.articleid | 4819 | pl |
dc.identifier.doi | 10.3390/jcm11164819 | pl |
dc.identifier.eissn | 2077-0383 | pl |
dc.identifier.issn | 2077-0383 | pl |
dc.identifier.uri | https://ruj.uj.edu.pl/xmlui/handle/item/299958 | |
dc.identifier.weblink | https://www.mdpi.com/2077-0383/11/16/4819 | pl |
dc.language | eng | pl |
dc.language.container | eng | pl |
dc.pbn.affiliation | Dziedzina nauk medycznych i nauk o zdrowiu : nauki medyczne | |
dc.rights | Udzielam licencji. Uznanie autorstwa 4.0 Międzynarodowa | |
dc.rights.licence | CC-BY | |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/legalcode.pl | |
dc.share.type | Otwarte czasopismo | |
dc.subject.en | carotid artery stenting | |
dc.subject.en | systematic review and meta-analysis | |
dc.subject.en | stent design | |
dc.subject.en | “mesh-covered” dual-layer stents | |
dc.subject.en | stroke prevention | |
dc.subtype | Article | pl |
dc.title | Clinical outcomes of second- versus first-generation carotid stents : a systematic review and meta-analysis | pl |
dc.title.journal | Journal of Clinical Medicine | pl |
dc.type | JournalArticle | pl |
dspace.entity.type | Publication |
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