%0 Journal Article %1 Siddiq2009 %A Siddiq, Farhan %A Memon, Muhammad Zeeshan %A Vazquez, Gabriela %A Safdar, Adnan %A Qureshi, Adnan I %D 2009 %J Neurosurgery %K Aged Angioplasty Angioplasty:methods Databases Factual Factual:statistics&numericaldata Female Follow-UpStudies Humans IntracranialArteriovenousMalformations IntracranialArteriovenousMalformations:surgery Male MiddleAged RetrospectiveStudies Stents TreatmentOutcome %N 6 %P 1024-33; discussion 1033-4 %R 10.1227/01.NEU.0000360138.54474.52 %T Comparison between primary angioplasty and stent placement for symptomatic intracranial atherosclerotic disease: meta-analysis of case series. %U http://www.ncbi.nlm.nih.gov/pubmed/19934961 %V 65 %X OBJECTIVE: To compare the short- and long-term rates of stroke-and/or-death associated with primary angioplasty alone and angioplasty with stent placement using a meta-analysis of published studies. Both primary angioplasty alone and angioplasty with stent placement have been proposed as treatment strategies for symptomatic intracranial atherosclerotic disease to reduce the risk of stroke-and/or-death with best medical treatment alone. However, it remains unclear which of these endovascular techniques offers the best risk reduction. METHODS: We identified pertinent studies published between January 1980 and May 2008 using a search on PubMed and Cochrane libraries, supplemented by a review of bibliographies of selected publications. The incidences of stroke-and/or-death were estimated for each report and pooled for both angioplasty alone and angioplasty with stent placement at 1 month and 1 year postintervention and then compared using a random-effects model. The association of year of publication and 1-year incidence of stroke-and/or-death was analyzed with meta-regression. RESULTS: After applying our selection criteria, we included 69 studies (33 primary angioplasty-alone studies 1027 patients and 36 studies of angioplasty with stent placement 1291 patients) in the analysis. There were a total of 91 stroke-and/or-deaths reported in the angioplasty-alone-treated group (8.9%; 95% confidence interval CI, 7.1%-10.6%), compared with 104 stroke-and/or-deaths in the angioplasty-with-stent-treated group (8.1%; 95% CI, 6.6%-9.5%) during a 1-month period (relative risk RR, 1.1; P = 0.48). The pooled incidence of 1-year stroke-and/or-death in patients treated with angioplasty alone was 19.7% (95% CI, 16.6%-23.5%), compared with 14.2% (95% CI, 11.9%-16.9%) in the angioplasty-with-stent-treated patients (RR, 1.39; P = 0.009). The incidence of technical success was 79.8% (95% CI, 74.7%-84.8%) in the angioplasty-alone group and 95% (95% CI, 93.4%-96.6%) in the angioplasty-with-stent-treated group (RR, 0.84; P < 0.0001). The pooled restenosis rate was 14.2% (95% CI, 11.8-16.6%) in the angioplasty-alone group, as compared with 11.1% (95% CI, 9.2%-13.0%) in the angioplasty-with-stent-treated group (RR, 1.28; P = 0.04). There was no effect of the publication year of the studies on the risk of stroke-and/or-death. CONCLUSION: Risk of 1-year stroke-and/or-death and rate of angiographic restenosis may be lower in symptomatic intracranial atherosclerosis patients treated by angioplasty with stent placement compared with patients treated by angioplasty alone. %@ 1524-4040; 0148-396X

@article{Siddiq2009, abstract = {OBJECTIVE: To compare the short- and long-term rates of stroke-and/or-death associated with primary angioplasty alone and angioplasty with stent placement using a meta-analysis of published studies. Both primary angioplasty alone and angioplasty with stent placement have been proposed as treatment strategies for symptomatic intracranial atherosclerotic disease to reduce the risk of stroke-and/or-death with best medical treatment alone. However, it remains unclear which of these endovascular techniques offers the best risk reduction. METHODS: We identified pertinent studies published between January 1980 and May 2008 using a search on PubMed and Cochrane libraries, supplemented by a review of bibliographies of selected publications. The incidences of stroke-and/or-death were estimated for each report and pooled for both angioplasty alone and angioplasty with stent placement at 1 month and 1 year postintervention and then compared using a random-effects model. The association of year of publication and 1-year incidence of stroke-and/or-death was analyzed with meta-regression. RESULTS: After applying our selection criteria, we included 69 studies (33 primary angioplasty-alone studies [1027 patients] and 36 studies of angioplasty with stent placement [1291 patients]) in the analysis. There were a total of 91 stroke-and/or-deaths reported in the angioplasty-alone-treated group (8.9%; 95% confidence interval [CI], 7.1%-10.6%), compared with 104 stroke-and/or-deaths in the angioplasty-with-stent-treated group (8.1%; 95% CI, 6.6%-9.5%) during a 1-month period (relative risk [RR], 1.1; P = 0.48). The pooled incidence of 1-year stroke-and/or-death in patients treated with angioplasty alone was 19.7% (95% CI, 16.6%-23.5%), compared with 14.2% (95% CI, 11.9%-16.9%) in the angioplasty-with-stent-treated patients (RR, 1.39; P = 0.009). The incidence of technical success was 79.8% (95% CI, 74.7%-84.8%) in the angioplasty-alone group and 95% (95% CI, 93.4%-96.6%) in the angioplasty-with-stent-treated group (RR, 0.84; P < 0.0001). The pooled restenosis rate was 14.2% (95% CI, 11.8-16.6%) in the angioplasty-alone group, as compared with 11.1% (95% CI, 9.2%-13.0%) in the angioplasty-with-stent-treated group (RR, 1.28; P = 0.04). There was no effect of the publication year of the studies on the risk of stroke-and/or-death. CONCLUSION: Risk of 1-year stroke-and/or-death and rate of angiographic restenosis may be lower in symptomatic intracranial atherosclerosis patients treated by angioplasty with stent placement compared with patients treated by angioplasty alone.}, added-at = {2023-02-03T11:44:35.000+0100}, author = {Siddiq, Farhan and Memon, Muhammad Zeeshan and Vazquez, Gabriela and Safdar, Adnan and Qureshi, Adnan I}, biburl = {https://www.bibsonomy.org/bibtex/2460f19fd05736120bc9c761c6e38a3bc/jepcastel}, city = {Department of Neurosurgery and Neurology, Zeenat Qureshi Stroke Research Center, University of Minnesota, Minneapolis, Minnesota 55455, USA. farhan_siddiq@hotmail.com}, doi = {10.1227/01.NEU.0000360138.54474.52}, interhash = {3f2e8ed32bb40c3264384bbf80406143}, intrahash = {460f19fd05736120bc9c761c6e38a3bc}, isbn = {1524-4040; 0148-396X}, issn = {1524-4040}, journal = {Neurosurgery}, keywords = {Aged Angioplasty Angioplasty:methods Databases Factual Factual:statistics&numericaldata Female Follow-UpStudies Humans IntracranialArteriovenousMalformations IntracranialArteriovenousMalformations:surgery Male MiddleAged RetrospectiveStudies Stents TreatmentOutcome}, month = {12}, note = {7450<m:linebreak></m:linebreak>JID: 7802914; ppublish;<m:linebreak></m:linebreak>Metaanàlisi; Sèrie de casos; Exemple}, number = 6, pages = {1024-33; discussion 1033-4}, pmid = {19934961}, timestamp = {2023-02-03T11:44:35.000+0100}, title = {Comparison between primary angioplasty and stent placement for symptomatic intracranial atherosclerotic disease: meta-analysis of case series.}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19934961}, volume = 65, year = 2009 }