Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Salcher, M; Naci, H; Law, TJ; Kuehne, T; Schubert, S; Kelm, M; Cardioproof Consortium.
Balloon Dilatation and Stenting for Aortic Coarctation: A Systematic Review and Meta-Analysis.
Circ Cardiovasc Interv. 2016; 9(6):
Doi: 10.1161/CIRCINTERVENTIONS.115.003153
[OPEN ACCESS]
Web of Science
PubMed
FullText
FullText_MUG
- Study Group Mitglieder der Med Uni Graz:
- Plank Gernot
- Altmetrics:
- Dimensions Citations:
- Plum Analytics:
- Scite (citation analytics):
- Abstract:
- There is no systematic assessment of available evidence on effectiveness and comparative effectiveness of balloon dilatation and stenting for aortic coarctation. 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). 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. © 2016 American Heart Association, Inc.
- Find related publications in this database (using NLM MeSH Indexing)
- Angioplasty, Balloon - adverse effects
- Angioplasty, Balloon - instrumentation
- Angioplasty, Balloon - mortality
- Aorta - abnormalities
- Aorta - drug effects
- Aorta - physiopathology
- Aortic Coarctation - diagnostic imaging
- Aortic Coarctation - mortality
- Aortic Coarctation - physiopathology
- Aortic Coarctation - therapy
- Arterial Pressure -
- Humans -
- Network Meta-Analysis -
- Odds Ratio -
- Risk Factors -
- Stents -
- Treatment Outcome -
- Find related publications in this database (Keywords)
- aneurysm
- angioplasty, balloon
- congenital
- meta-analysis
- stent