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Endovascular vs. medical therapy in symptomatic vertebral artery stenosis: a meta-analysis.

Abstract：

:This meta-analysis aims to compare percutaneous transluminal angioplasty (PTA) to medical treatment (MT) for symptomatic vertebral artery stenosis (SVAS) treatment. We searched PubMed, Springer, Google Scholar, Clinical Trials, Cochrane Central, Chinese National Knowledge Infrastructure, and China Biological Medicine databases. All relevant comparative trials were included. All summary estimates were calculated by random-effect models. Ten comparative trials involving 672 patients were identified. Within 30-day follow-up, there was no significant difference between PTA plus MT and MT alone in vascular death, any stroke, posterior circulation TIA, posterior circulation infarction, and ischemic stroke (all P > 0.05). With a follow-up of more than 1 year, no significant difference was found between PTA plus MT and MT alone in all-cause death (3 vs. 7 %, P = 0.24), vascular death (4 vs. 7 %, P = 0.34), posterior circulation stroke (5 vs. 8 %, P = 0.48), posterior circulation ischemic events (8 vs. 25 %, P = 0.23), posterior circulation TIA (10 vs. 38 %, P = 0.11), posterior circulation infarction (6 vs. 12 %, P = 0.51), vertebral artery occlusion (6 vs. 12 %, P = 0.58), and in secondary long-term events, including any stroke, anterior circulation stroke, hemorrhagic stroke, and myocardial infarction (all P > 0.05), although PTA plus MT could largely reduce the vertebral artery stenosis rate [MD 63.05 %, 95 % CI (32.77-93.34 %), P < 0.01]. Hence, PTA plus MT may be not superior to MT alone for SVAS treatment. Larger randomized trials are needed to verify the optimum therapy for SVAS.

journal_name

J Neurol

journal_title

Journal of neurology

authors

Feng H,Xie Y,Mei B,Liu Y,Li B,Yin C,Wang T,Liu Y

doi

10.1007/s00415-016-8267-0

subject

Has Abstract

pub_date

2017-05-01 00:00:00

pages

829-838

issue

5

eissn

0340-5354

issn

1432-1459

pii

10.1007/s00415-016-8267-0

journal_volume

264

pub_type

杂志文章,meta分析,评审

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