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Comparing Percutaneous Transluminal Angioplasty and Stent Placement for Treatment of Subclavian Arterial Occlusive Disease: A Systematic Review and Meta-Analysis

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A Correction to this article was published on 26 January 2018

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Abstract

Background and Purpose

Subclavian artery occlusive disease (SAOD) is often associated with cerebrovascular symptoms such as subclavian steal syndrome and stroke. We conducted a systematic review and meta-analysis to compare percutaneous transluminal angioplasty (PTA) and stent placement for the treatment of SAOD.

Materials and Methods

We searched Medline, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus through October 16, 2014. From each study, we abstracted baseline patient characteristics, study design variables, and outcome data including rates of technical success, primary patency (≤2 and >2 years follow-up), symptom resolution, and complications. Meta-analysis was performed using a random-effects model.

Results

A total of 35 non-comparative studies with 1726 patients were included. Technical success rate was significantly higher in the stent group than the PTA group (92.8 vs 86.8 %, p = 0.007). Long-term primary patency rates (76.9 vs 79.6 %, p = 0.729) and symptom resolution rates (82.2 vs 73.0 %, p = 0.327) were not statistically different. There was no statistically significant difference in the rates of stroke or death.

Conclusion

Stent placement for treatment of SAOD may be associated with higher rates of technical success but similar rates of symptom resolution and long-term outcomes. The confidence in the available estimates is low. Further comparative studies are needed to guide patients and clinicians in shared decision making.

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Change history

  • 26 January 2018

    The original version of this paper contained an error.

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Authors and Affiliations

  1. Evidence-Based Practice Research Program, Mayo Clinic, 200 1st Street Southwest, Harwick Building 2-50, Rochester, MN, 55905, USA

    Ahmed T. Ahmed, Khaled Mohammed & M. Hassan Murad

  2. Division of Preventive, Occupational and Aerospace Medicine, Mayo Clinic, 200 1st Street Southwest, Rochester, MN, 55905, USA

    Ahmed T. Ahmed, Khaled Mohammed & M. Hassan Murad

  3. Department of Diagnostic Radiology and Molecular Imaging, Oakland University William Beaumont School of Medicine, 3601 W 13 Mile Road, Royal Oak, MI, 48073, USA

    Monzer Chehab

  4. Department of Radiology, Mayo Clinic, 200 1st Street Southwest, Rochester, MN, 55905, USA

    Waleed Brinjikji, Harry Cloft & Haraldur Bjarnason

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Correspondence to Ahmed T. Ahmed.

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A correction to this article is available online at https://doi.org/10.1007/s00270-018-1881-8.

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Ahmed, A.T., Mohammed, K., Chehab, M. et al. Comparing Percutaneous Transluminal Angioplasty and Stent Placement for Treatment of Subclavian Arterial Occlusive Disease: A Systematic Review and Meta-Analysis. Cardiovasc Intervent Radiol 39, 652–667 (2016). https://doi.org/10.1007/s00270-015-1250-9

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