Unit:
Speciality Endovascular TechniquesLibrary of the School of Health Sciences
Author:
Paraskevas Kosmas
Supervisors info:
Γερουλάκος Γεώργιος, Καθηγητής, Ιατρική Σχολή, Ε.Κ.Π.Α.
Κακίσης Ιωάννης, Καθηγητής, Ιατρική Σχολή, Ε.Κ.Π.Α.
Χατζηιωάννου Αχιλλέας, Καθηγητής, Ιατρική Σχολή, Ε.Κ.Π.Α.
Original Title:
Συστηματική ανασκόπηση της βιβλιογραφίας και μετα-ανάλυση των αποτελεσμάτων της διατραχηλικής τοποθέτησης ενδονάρθηκα καρωτίδας με αναστροφή ροής
Translated title:
A systematic review of the literature and meta-analysis of the results of transcarotid artery revascularization
Summary:
Objective: Transcervical carotid artery stenting (CAS) has emerged as an alternative to transfemoral CAS. The aim of the present systematic review and meta-analysis was to investigate outcomes specifically after transcervical CAS with flow reversal.
Methods: An electronic search of PubMed/Medline, Embase, and the Cochrane databases was carried out to identify studies reporting outcomes after transcervical CAS with flow reversal. Crude event rates for outcomes of interest were estimated by simple pooling of data. A proportion meta-analysis was also performed to estimate pooled outcome rates.
Results: A total of 18 studies (n = 2,110 transcervical CAS procedures with flow reversal) were identified. A high technical success (98.25%) and a low mortality rate (0.48%) were recorded. The crude rates of major/minor stroke, transient ischemic attack (TIA) and myocardial infarction were 0.71%, 0.90%, 0.57% and 0.57%, respectively, while a cranial nerve injury occurred in 0.28% of the procedures. A neck hematoma was reported in 1.04% of the procedures, a carotid artery dissection occurred in 0.76% of the interventions, while in 1.09% of the cases conversion to carotid endarterectomy was required.
Conclusions: This updated systematic review and meta-analysis demonstrated that transcervical CAS with flow reversal is associated with high technical success, almost zero mortality and very low major/minor stroke, myocardial infarction and complication rates.
Main subject category:
Health Sciences
Keywords:
Carotid stenosis, Carotid artery stenting, Stroke, Meta-analysis
