METHODS: Medical databases were searched on September 17, 2023. 17 trials and 7 treatments were selected. Outcomes were primary patency, target lesion revascularization (TLR), major amputation and all-cause mortality at 3 and/or 5 years.
RESULTS: Regarding 3-year primary patency, drug-eluting stents (DES) was the best and better than balloon angioplasty (BA; odds ratio [OR], 4.96; 95% confidence interval [CI], 2.68-9.18), bare metal stents (BMS; OR, 2.81; 95% CI, 1.45-5.46), cryoplasty (OR, 6.75; 95% CI, 2.76-16.50), covered stents (CS; OR, 3.25; 95% CI, 1.19-8.87) and drug-coated balloons (DCB; OR, 2.04; 95% CI, 1.14-3.63). Regarding 5-year primary patency, DES was the best and better than BMS (OR, 2.34; 95% CI, 1.10-4.99). Regarding 3-year TLR, DES was the best and better than BA (OR, 0.24; 95% CI, 0.13-0.44). Regarding 5-year TLR, DES was the best and better than BA (OR, 0.20; 95% CI, 0.09-0.42) and balloon angioplasty with brachytherapy (OR, 0.21; 95% CI, 0.06-0.74). Regarding 3- and 5-year major amputation, DCB was the best. Regarding 3-year mortality, DES was the best and better than CS (OR, 0.09; 95% CI, 0.01-0.67).
CONCLUSIONS: DES was the best treatment regarding 3-year primary patency, TLR and mortality, and DCB was the best regarding major amputation. DES was the best treatment regarding 5-year TLR, and DCB was the best regarding primary patency and major amputation. DES and DCB should be given priority in treating femoropopliteal lesions.
方法:于2023年9月17日检索了医学数据库。选择17项试验和7种治疗方法。结果是初级通畅,靶病变血运重建(TLR),严重截肢和3年和/或5年全因死亡率。
结果:关于3年的主要通畅性,药物洗脱支架(DES)是最好的,优于球囊血管成形术(BA;优势比[OR],4.96;95%置信区间[CI],2.68-9.18),裸露金属支架(BMS;或,2.81;95%CI,1.45-5.46),冷冻成形术(或,6.75;95%CI,2.76-16.50),覆膜支架(CS;或,3.25;95%CI,1.19-8.87)和药物涂层球囊(DCB;或,2.04;95%CI,1.14-3.63)。关于5年的初级通畅,DES是最好的,比BMS更好(或,2.34;95%CI,1.10-4.99)。关于3年TLR,DES是最好的,也比BA好(或者,0.24;95%CI,0.13-0.44)。关于5年TLR,DES是最好的,也比BA好(或者,0.20;95%CI,0.09-0.42)和近距离放射治疗球囊血管成形术(OR,0.21;95%CI,0.06-0.74)。关于3年和5年的严重截肢手术,DCB是最好的。关于3年死亡率,DES是最好的,也比CS好(或者,0.09;95%CI,0.01-0.67)。
结论:DES是3年原发性通畅的最佳治疗方法,TLR和死亡率,DCB是关于大截肢最好的。DES是5年TLR的最佳治疗方法,DCB在主要通畅性和主要截肢方面是最好的。DES和DCB在治疗股pop病变时应优先考虑。