Abstract：
UNASSIGNED: This study aimed to assess the efficacy and safety outcome of covered stents (CSs), as compared with bare-metal stents (BMSs), for the treatment of patients with aortoiliac occlusive disease (AIOD).
UNASSIGNED: A systematic literature search was conducted in PubMed, Embase, and Cochrane Library up to August 2023 to identify all studies comparing efficacy and safety outcomes of CSs versus BMSs for treating AIOD. Our outcome was primary patency, secondary patency, technical success, ankle-brachial index (ABI) variation, target lesion revascularization (TLR), limb salvage, complications, and long-term survival. Dichotomous outcomes were pooled as relative risks (RR) or hazard ratio with the 95% confidence interval (CI). Continuous outcomes were pooled as weighted mean differences and 95% CI. Model selection was based on the heterogeneity of the included studies.
UNASSIGNED: There were 10 studies (2 randomized controlled trials, 8 retrospective cohort studies), comprising 1676 sample size. Compared with BMSs, CSs use was associated with better primary patency of patients with a Trans-Atlantic Inter-Society Consensus II (TASC) D lesion (RR, 1.15, 95% CI, 1.04 to 1.27, p=0.007), TLR (RR, 0.39, 95% CI, 0.27 to 0.56, p<0.001), technical success (RR, 1.01, 95% CI, 1.00 to 1.02, p=0.010), and long-term survival (RR, 1.06, 95% CI, 1.01 to 1.11, p=0.020). There is no difference between CSs and BMSs regarding primary patency of all patients, secondary patency, variation in ABI, limb salvage, and complications.
UNASSIGNED: Compared with BMSs, CSs used in AIOD was associated with more favorable primary patency in patients with TASC D lesions, TLR, technical success rates, and patient long-term survival. These results provide evidence of the advantages of using CSs for AIOD treatment. Future studies focusing on long-term variations in ABI, primary patency of different degrees of calcification, vascular segments, and TASC classification are warranted.
CONCLUSIONS: Although several studies evaluated the clinical efficacy of CS in the context of AIOD treatment, the significance and consistency of these findings were not determined to date. We found that CS was used in AIOD associated with better technical success rate, long-term patient survival, lower target lesion revascularization, and higher primary patency of patients with a Trans-Atlantic Inter-Society Consensus II D lesion when compared with BMSs. Our study provides evidence supporting the superiority of CSs over BMSs in the treatment of AIOD, and furnishing clinicians with guidance for treatment decisions.
UNASSIGNED: A systematic literature search was conducted in PubMed, Embase, and Cochrane Library up to August 2023 to identify all studies comparing efficacy and safety outcomes of CSs versus BMSs for treating AIOD. Our outcome was primary patency, secondary patency, technical success, ankle-brachial index (ABI) variation, target lesion revascularization (TLR), limb salvage, complications, and long-term survival. Dichotomous outcomes were pooled as relative risks (RR) or hazard ratio with the 95% confidence interval (CI). Continuous outcomes were pooled as weighted mean differences and 95% CI. Model selection was based on the heterogeneity of the included studies.
UNASSIGNED: There were 10 studies (2 randomized controlled trials, 8 retrospective cohort studies), comprising 1676 sample size. Compared with BMSs, CSs use was associated with better primary patency of patients with a Trans-Atlantic Inter-Society Consensus II (TASC) D lesion (RR, 1.15, 95% CI, 1.04 to 1.27, p=0.007), TLR (RR, 0.39, 95% CI, 0.27 to 0.56, p<0.001), technical success (RR, 1.01, 95% CI, 1.00 to 1.02, p=0.010), and long-term survival (RR, 1.06, 95% CI, 1.01 to 1.11, p=0.020). There is no difference between CSs and BMSs regarding primary patency of all patients, secondary patency, variation in ABI, limb salvage, and complications.
UNASSIGNED: Compared with BMSs, CSs used in AIOD was associated with more favorable primary patency in patients with TASC D lesions, TLR, technical success rates, and patient long-term survival. These results provide evidence of the advantages of using CSs for AIOD treatment. Future studies focusing on long-term variations in ABI, primary patency of different degrees of calcification, vascular segments, and TASC classification are warranted.
CONCLUSIONS: Although several studies evaluated the clinical efficacy of CS in the context of AIOD treatment, the significance and consistency of these findings were not determined to date. We found that CS was used in AIOD associated with better technical success rate, long-term patient survival, lower target lesion revascularization, and higher primary patency of patients with a Trans-Atlantic Inter-Society Consensus II D lesion when compared with BMSs. Our study provides evidence supporting the superiority of CSs over BMSs in the treatment of AIOD, and furnishing clinicians with guidance for treatment decisions.
摘要：
■本研究旨在评估覆膜支架（CSs）的疗效和安全性结果，与裸金属支架(BMS)相比，用于治疗主髂动脉闭塞性疾病（AIOD）的患者。
■在PubMed进行了系统的文献检索，Embase,和Cochrane图书馆截至2023年8月，以确定所有比较CSs与BMS治疗AIOD的疗效和安全性结果的研究。我们的结果是初级通畅，二级通畅，技术上的成功,踝臂指数(ABI)变异,靶病变血运重建(TLR),肢体抢救,并发症,和长期生存。将二分结果合并为相对风险（RR）或风险比，95%置信区间（CI）。连续结果汇总为加权平均差异和95%CI。模型选择基于纳入研究的异质性。
■共有10项研究(2项随机对照试验，8项回顾性队列研究)，包含1676个样本量。与BMS相比，CSs的使用与跨大西洋社会共识II（TASC）D病变患者的原发性通畅性更好（RR，1.15，95%CI，1.04至1.27，p=0.007），TLR(RR,0.39，95%CI，0.27至0.56，p<0.001)，技术成功(RR，1.01，95%CI，1.00至1.02，p=0.010），和长期生存率(RR，1.06，95%CI，1.01至1.11，p=0.020）。CSs和BMS在所有患者的主要通畅性方面没有差异，二级通畅，ABI的变异，肢体抢救,和并发症。
■与BMS相比，用于AIOD的CSs与TASCD病变患者更有利的原发性通畅性相关，TLR,技术成功率,和患者的长期生存。这些结果提供了使用CSs进行AIOD治疗的优点的证据。未来的研究集中在ABI的长期变化，原发性通畅程度不同的钙化，血管段,和TASC分类是有保证的。
结论：尽管一些研究评估了CS在AIOD治疗中的临床疗效，这些结果的显著性和一致性迄今尚未确定.我们发现在AIOD中使用CS与更好的技术成功率相关，患者长期生存，下靶病变血运重建，与BMS相比，具有跨大西洋社会共识IID病变的患者的主要通畅性较高。我们的研究提供了支持CSs在AIOD治疗中优于BMS的证据，并为临床医生提供治疗决策指导。
■在PubMed进行了系统的文献检索，Embase,和Cochrane图书馆截至2023年8月，以确定所有比较CSs与BMS治疗AIOD的疗效和安全性结果的研究。我们的结果是初级通畅，二级通畅，技术上的成功,踝臂指数(ABI)变异,靶病变血运重建(TLR),肢体抢救,并发症,和长期生存。将二分结果合并为相对风险（RR）或风险比，95%置信区间（CI）。连续结果汇总为加权平均差异和95%CI。模型选择基于纳入研究的异质性。
■共有10项研究(2项随机对照试验，8项回顾性队列研究)，包含1676个样本量。与BMS相比，CSs的使用与跨大西洋社会共识II（TASC）D病变患者的原发性通畅性更好（RR，1.15，95%CI，1.04至1.27，p=0.007），TLR(RR,0.39，95%CI，0.27至0.56，p<0.001)，技术成功(RR，1.01，95%CI，1.00至1.02，p=0.010），和长期生存率(RR，1.06，95%CI，1.01至1.11，p=0.020）。CSs和BMS在所有患者的主要通畅性方面没有差异，二级通畅，ABI的变异，肢体抢救,和并发症。
■与BMS相比，用于AIOD的CSs与TASCD病变患者更有利的原发性通畅性相关，TLR,技术成功率,和患者的长期生存。这些结果提供了使用CSs进行AIOD治疗的优点的证据。未来的研究集中在ABI的长期变化，原发性通畅程度不同的钙化，血管段,和TASC分类是有保证的。
结论：尽管一些研究评估了CS在AIOD治疗中的临床疗效，这些结果的显著性和一致性迄今尚未确定.我们发现在AIOD中使用CS与更好的技术成功率相关，患者长期生存，下靶病变血运重建，与BMS相比，具有跨大西洋社会共识IID病变的患者的主要通畅性较高。我们的研究提供了支持CSs在AIOD治疗中优于BMS的证据，并为临床医生提供治疗决策指导。
