Endovascular brachytherapy and restenosis following lower limb angioplasty: Systematic review and meta-analysis of randomized clinical trials

International Journal of Surgery
David MitchellStewart R Walsh

Abstract

Restenosis is a fundamental weakness of percutaneous femoropopliteal angioplasty (PTA). The potential of endovascular brachytherapy (EVBT) to reduce restenosis has been evaluated in randomized clinical trials, but no pooled analysis has been undertaken. A systematic review was undertaken to identify randomized controlled trials in which PTA alone was compared to PTA plus EVBT. The Pubmed and Medline databases, American Heart Association OASIS database and conference proceedings from the Peripheral Vascular Surgery Society and Vascular Society of Great Britain and Ireland were searched. Eligible studies were randomised controlled trials comparing PTA to PTA plus EVBT in human subjects with at least one clinical outcome reported (restenosis, complications, patency). Study quality was assessed by the Jadad score. Random-effects modeling was used to generate pooled effect size estimates. Six trials (687 patients) were identified. EVBT reduced 12-month restenosis rates (pooled odds ratio 0.50; 95% CI 0.301-0.836; p=0.008). The benefit disappeared by 24 months. The short-term risk of new lesions elsewhere in the treated artery was significantly increased by EVBT (pooled odds ratio 8.65; 95% CI 2.176-34.391; p=0.002). While limited by...Continue Reading

References

Sep 1, 1986·Controlled Clinical Trials·R DerSimonian, N Laird
Feb 1, 1996·Controlled Clinical Trials·A R JadadH J McQuay
Feb 3, 2005·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Boris PokrajacErich Minar
Dec 21, 2005·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Nicolas DiehmIris Baumgartner
Feb 27, 2007·Vascular Health and Risk Management·Martin Schillinger, Erich Minar
Jul 1, 2009·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Nicolas W Shammas

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Citations

Jan 9, 2014·The Cochrane Database of Systematic Reviews·Alina AndrasGerard Stansby
Sep 28, 2015·Clinical Hemorheology and Microcirculation·Christoph ThalhammerBeatrice R Amann-Vesti
Aug 16, 2012·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Erich Minar

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