Cargando…
Stenting or angioplasty for the treatment of deep vein thrombosis: Systematic review and meta-analysis of randomized controlled trials
Although the cornerstone treatment for deep vein thrombosis (DVT) remains anticoagulation, clinicians perform stenting or angioplasty (SA) in particular patients. To assess the effects of SA in this setting, we performed a systematic review of randomized controlled trials. METHODS: Based on the Coch...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10237682/ https://www.ncbi.nlm.nih.gov/pubmed/37266612 http://dx.doi.org/10.1097/MD.0000000000033924 |
_version_ | 1785053196650020864 |
---|---|
author | Flumignan, Ronald Luiz Gomes Civile, Vinicius Tassoni Areias, Libnah Leal Flumignan, Carolina Dutra Queiroz Amorim, Jorge Eduardo Lopes, Renato Delascio Nakano, Luis C. U. Baptista-Silva, Jose Carlos Costa |
author_facet | Flumignan, Ronald Luiz Gomes Civile, Vinicius Tassoni Areias, Libnah Leal Flumignan, Carolina Dutra Queiroz Amorim, Jorge Eduardo Lopes, Renato Delascio Nakano, Luis C. U. Baptista-Silva, Jose Carlos Costa |
author_sort | Flumignan, Ronald Luiz Gomes |
collection | PubMed |
description | Although the cornerstone treatment for deep vein thrombosis (DVT) remains anticoagulation, clinicians perform stenting or angioplasty (SA) in particular patients. To assess the effects of SA in this setting, we performed a systematic review of randomized controlled trials. METHODS: Based on the Cochrane standards, we searched the Cochrane CENTRAL, MEDLINE, Embase, CINAHL, LILACS and IBECS databases, and trial registries. Our primary outcomes were post-thrombotic syndrome (PTS), venous thromboembolism (VTE) and all-cause mortality. RESULTS: We included 7 randomized controlled trial (1485 participants). There was no clinically significant difference between SA and best medical practice (BMP) for the additional treatment of acute DVT regarding PTS (standardized mean difference −7.87, 95% confidence interval [CI] −12.13 to −3.61; very low-certainty) and VTE (risk ratio [RR] 1.19, 95% CI 0.28–5.07, very low-certainty), and no deaths. Compared to BMP, the SA plus BMP and thrombolysis results in little to no difference in PTS (mean difference [MD] −1.07, 95% CI −1.12 to −1.02, moderate-certainty), VTE (RR 1.48, 95% CI 0.95–2.31, low-certainty), and mortality (RR 0.92, 95% CI 0.34–2.52, low-certainty). There was no clinical difference between stenting and BMP for chronic DVT regarding PTS (MD 2.73, 95% CI −2.10 to 7.56, very low certainty) and no VTE and death events. CONCLUSIONS: SA results in little to no difference in PTS, VTE and mortality in acute DVT compared to BMP. The evidence regarding SA in chronic DVT and whether SA, compared to BMP and thrombolysis, decreases PTS and VTE in acute DVT is uncertain. Open Science Framework (osf.io/f2dm6) |
format | Online Article Text |
id | pubmed-10237682 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-102376822023-06-03 Stenting or angioplasty for the treatment of deep vein thrombosis: Systematic review and meta-analysis of randomized controlled trials Flumignan, Ronald Luiz Gomes Civile, Vinicius Tassoni Areias, Libnah Leal Flumignan, Carolina Dutra Queiroz Amorim, Jorge Eduardo Lopes, Renato Delascio Nakano, Luis C. U. Baptista-Silva, Jose Carlos Costa Medicine (Baltimore) 7100 Although the cornerstone treatment for deep vein thrombosis (DVT) remains anticoagulation, clinicians perform stenting or angioplasty (SA) in particular patients. To assess the effects of SA in this setting, we performed a systematic review of randomized controlled trials. METHODS: Based on the Cochrane standards, we searched the Cochrane CENTRAL, MEDLINE, Embase, CINAHL, LILACS and IBECS databases, and trial registries. Our primary outcomes were post-thrombotic syndrome (PTS), venous thromboembolism (VTE) and all-cause mortality. RESULTS: We included 7 randomized controlled trial (1485 participants). There was no clinically significant difference between SA and best medical practice (BMP) for the additional treatment of acute DVT regarding PTS (standardized mean difference −7.87, 95% confidence interval [CI] −12.13 to −3.61; very low-certainty) and VTE (risk ratio [RR] 1.19, 95% CI 0.28–5.07, very low-certainty), and no deaths. Compared to BMP, the SA plus BMP and thrombolysis results in little to no difference in PTS (mean difference [MD] −1.07, 95% CI −1.12 to −1.02, moderate-certainty), VTE (RR 1.48, 95% CI 0.95–2.31, low-certainty), and mortality (RR 0.92, 95% CI 0.34–2.52, low-certainty). There was no clinical difference between stenting and BMP for chronic DVT regarding PTS (MD 2.73, 95% CI −2.10 to 7.56, very low certainty) and no VTE and death events. CONCLUSIONS: SA results in little to no difference in PTS, VTE and mortality in acute DVT compared to BMP. The evidence regarding SA in chronic DVT and whether SA, compared to BMP and thrombolysis, decreases PTS and VTE in acute DVT is uncertain. Open Science Framework (osf.io/f2dm6) Lippincott Williams & Wilkins 2023-06-02 /pmc/articles/PMC10237682/ /pubmed/37266612 http://dx.doi.org/10.1097/MD.0000000000033924 Text en Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC) (https://creativecommons.org/licenses/by-nc/4.0/) , where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. |
spellingShingle | 7100 Flumignan, Ronald Luiz Gomes Civile, Vinicius Tassoni Areias, Libnah Leal Flumignan, Carolina Dutra Queiroz Amorim, Jorge Eduardo Lopes, Renato Delascio Nakano, Luis C. U. Baptista-Silva, Jose Carlos Costa Stenting or angioplasty for the treatment of deep vein thrombosis: Systematic review and meta-analysis of randomized controlled trials |
title | Stenting or angioplasty for the treatment of deep vein thrombosis: Systematic review and meta-analysis of randomized controlled trials |
title_full | Stenting or angioplasty for the treatment of deep vein thrombosis: Systematic review and meta-analysis of randomized controlled trials |
title_fullStr | Stenting or angioplasty for the treatment of deep vein thrombosis: Systematic review and meta-analysis of randomized controlled trials |
title_full_unstemmed | Stenting or angioplasty for the treatment of deep vein thrombosis: Systematic review and meta-analysis of randomized controlled trials |
title_short | Stenting or angioplasty for the treatment of deep vein thrombosis: Systematic review and meta-analysis of randomized controlled trials |
title_sort | stenting or angioplasty for the treatment of deep vein thrombosis: systematic review and meta-analysis of randomized controlled trials |
topic | 7100 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10237682/ https://www.ncbi.nlm.nih.gov/pubmed/37266612 http://dx.doi.org/10.1097/MD.0000000000033924 |
work_keys_str_mv | AT flumignanronaldluizgomes stentingorangioplastyforthetreatmentofdeepveinthrombosissystematicreviewandmetaanalysisofrandomizedcontrolledtrials AT civileviniciustassoni stentingorangioplastyforthetreatmentofdeepveinthrombosissystematicreviewandmetaanalysisofrandomizedcontrolledtrials AT areiaslibnahleal stentingorangioplastyforthetreatmentofdeepveinthrombosissystematicreviewandmetaanalysisofrandomizedcontrolledtrials AT flumignancarolinadutraqueiroz stentingorangioplastyforthetreatmentofdeepveinthrombosissystematicreviewandmetaanalysisofrandomizedcontrolledtrials AT amorimjorgeeduardo stentingorangioplastyforthetreatmentofdeepveinthrombosissystematicreviewandmetaanalysisofrandomizedcontrolledtrials AT lopesrenatodelascio stentingorangioplastyforthetreatmentofdeepveinthrombosissystematicreviewandmetaanalysisofrandomizedcontrolledtrials AT nakanoluiscu stentingorangioplastyforthetreatmentofdeepveinthrombosissystematicreviewandmetaanalysisofrandomizedcontrolledtrials AT baptistasilvajosecarloscosta stentingorangioplastyforthetreatmentofdeepveinthrombosissystematicreviewandmetaanalysisofrandomizedcontrolledtrials |