PDF(Pubmed)
Abstract：
UNASSIGNED: The role of atherectomy in treating femoropopliteal disease has been evolving rapidly. However, the clinical efficacy and safety of adjunctive atherectomy to percutaneous balloon angioplasty (BA) (plain balloon and drug-coated BA) remains controversial. We sought to perform a meta-analysis comparing atherectomy plus balloon angioplasty (ABA) versus BA alone in treating femoropopliteal disease.
UNASSIGNED: We searched PubMed, Cochrane Central Register of Clinical Trials, EMBASE, and ClinicalTrials.gov (from inception through January 10, 2022) for studies comparing ABA versus BA for femoropopliteal disease. We used a random-effects model to calculate risk ratio (RR) with 95% CIs. Target lesion revascularization (TLR), primary patency, and bailout stenting were the primary outcomes.
UNASSIGNED: Nine studies with 699 patients were included (4 randomized and 5 retrospective studies). Compared to BA alone, the ABA group showed a significant decrease in TLR driven by nonrandomized studies (RR 0.59; 95% CI, 0.40-0.85; P = .005) and bailout stenting (RR, 0.32; 95% CI, 0.21-0.48; P < .0001). There was no significant difference in TLR when the analysis was performed including only randomized trials. There was no significant difference in the primary patency between the 2 groups (RR, 1.04; 95% CI, 0.95-1.14; P = .37).
UNASSIGNED: Data from randomized trials suggest that compared with BA alone, the combination of atherectomy and BA showed no difference in TLR or primary patency. In observational studies, TLR and bailout stenting were reduced in ABA group but there was no difference in primary patency. Further studies are needed to investigate the clinical outcomes of atherectomy combined with BA in femoropopliteal lesions compared with BA alone.
UNASSIGNED: We searched PubMed, Cochrane Central Register of Clinical Trials, EMBASE, and ClinicalTrials.gov (from inception through January 10, 2022) for studies comparing ABA versus BA for femoropopliteal disease. We used a random-effects model to calculate risk ratio (RR) with 95% CIs. Target lesion revascularization (TLR), primary patency, and bailout stenting were the primary outcomes.
UNASSIGNED: Nine studies with 699 patients were included (4 randomized and 5 retrospective studies). Compared to BA alone, the ABA group showed a significant decrease in TLR driven by nonrandomized studies (RR 0.59; 95% CI, 0.40-0.85; P = .005) and bailout stenting (RR, 0.32; 95% CI, 0.21-0.48; P < .0001). There was no significant difference in TLR when the analysis was performed including only randomized trials. There was no significant difference in the primary patency between the 2 groups (RR, 1.04; 95% CI, 0.95-1.14; P = .37).
UNASSIGNED: Data from randomized trials suggest that compared with BA alone, the combination of atherectomy and BA showed no difference in TLR or primary patency. In observational studies, TLR and bailout stenting were reduced in ABA group but there was no difference in primary patency. Further studies are needed to investigate the clinical outcomes of atherectomy combined with BA in femoropopliteal lesions compared with BA alone.
摘要：
■动脉粥样硬化切除术在治疗股pop疾病中的作用正在迅速发展。然而,经皮球囊成形术（BA）（普通球囊和药物涂层BA）的辅助斑块切除术的临床疗效和安全性仍存在争议。我们试图进行一项荟萃分析，比较斑块切除术加球囊血管成形术（ABA）与单用BA治疗股pop疾病。
■我们搜索了PubMed，Cochrane临床试验中央注册中心,EMBASE,和ClinicalTrials.gov（从开始到2022年1月10日），用于比较ABA和BA治疗股pop疾病的研究。我们使用随机效应模型计算95%CI的风险比(RR)。靶病变血运重建(TLR),初级通畅，救助支架是主要结果。
■纳入了9项研究，共699名患者（4项随机研究和5项回顾性研究）。与单独的BA相比，ABA组显示出由非随机研究（RR0.59;95％CI，0.40-0.85;P=0.005）和救助支架（RR，0.32；95%CI，0.21-0.48；P<0.0001）。进行分析时，TLR没有显着差异，仅包括随机试验。两组之间的主要通畅性没有显着差异（RR，1.04；95%CI，0.95-1.14；P=.37）。
■来自随机试验的数据表明，与单独的BA相比，斑块切除和BA联合显示TLR或原发通畅性无差异.在观察性研究中,ABA组TLR和救助支架降低，但原发通畅性无差异。需要进一步的研究来研究与单用BA相比，动脉粥样硬化切除联合BA在股pop病变中的临床效果。
■我们搜索了PubMed，Cochrane临床试验中央注册中心,EMBASE,和ClinicalTrials.gov（从开始到2022年1月10日），用于比较ABA和BA治疗股pop疾病的研究。我们使用随机效应模型计算95%CI的风险比(RR)。靶病变血运重建(TLR),初级通畅，救助支架是主要结果。
■纳入了9项研究，共699名患者（4项随机研究和5项回顾性研究）。与单独的BA相比，ABA组显示出由非随机研究（RR0.59;95％CI，0.40-0.85;P=0.005）和救助支架（RR，0.32；95%CI，0.21-0.48；P<0.0001）。进行分析时，TLR没有显着差异，仅包括随机试验。两组之间的主要通畅性没有显着差异（RR，1.04；95%CI，0.95-1.14；P=.37）。
■来自随机试验的数据表明，与单独的BA相比，斑块切除和BA联合显示TLR或原发通畅性无差异.在观察性研究中,ABA组TLR和救助支架降低，但原发通畅性无差异。需要进一步的研究来研究与单用BA相比，动脉粥样硬化切除联合BA在股pop病变中的临床效果。
