Cargando…

Meta-analysis of Individual Patient Data After Kissing Stent Treatment for Aortoiliac Occlusive Disease

Purpose: To evaluate short- and long-term technical and clinical outcomes after kissing stent treatment of aortoiliac occlusive disease (AIOD) based on an individual participant data (IPD) meta-analysis. Materials and Methods: A search of the Scopus database identified 156 articles on KS treatment o...

Descripción completa

Detalles Bibliográficos
Autores principales: Groot Jebbink, Erik, Holewijn, Suzanne, Versluis, Michel, Grimme, Frederike, Hinnen, Jan Willem, Sixt, Sebastian, Angle, John F., Dorigo, Walter, Reijnen, Michel M. P. J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6330696/
https://www.ncbi.nlm.nih.gov/pubmed/30499352
http://dx.doi.org/10.1177/1526602818810535
_version_ 1783387015543259136
author Groot Jebbink, Erik
Holewijn, Suzanne
Versluis, Michel
Grimme, Frederike
Hinnen, Jan Willem
Sixt, Sebastian
Angle, John F.
Dorigo, Walter
Reijnen, Michel M. P. J.
author_facet Groot Jebbink, Erik
Holewijn, Suzanne
Versluis, Michel
Grimme, Frederike
Hinnen, Jan Willem
Sixt, Sebastian
Angle, John F.
Dorigo, Walter
Reijnen, Michel M. P. J.
author_sort Groot Jebbink, Erik
collection PubMed
description Purpose: To evaluate short- and long-term technical and clinical outcomes after kissing stent treatment of aortoiliac occlusive disease (AIOD) based on an individual participant data (IPD) meta-analysis. Materials and Methods: A search of the Scopus database identified 156 articles on KS treatment of AIOD; of these 22 met the inclusion criteria. Authors of 19 articles with contact information were approached to join an IPD consortium. Eight author groups responded and 5 provided anonymized data for merging into an IPD database. The number of included procedures was equal before and after 2005. The primary study outcome was the cumulative patency at 24 months. Secondary outcomes were patency at up to 60 months, complications, and changes in Rutherford category and ankle-brachial index. The predictive value of stent protrusion length, pre-/postdilation, stent type, and patient demographics on primary patency were examined with Cox proportional hazard modeling; outcomes are reported as the hazard ratio (HR). The Kaplan-Meier method was employed to estimate patency rates. Results: In total, 605 (40.9%) of 1480 patients presented in the literature were included in the IPD analysis. The indication for intervention was intermittent claudication in 84.2% and critical limb ischemia in 15.8%. Lesions were classified as TransAtlantic Inter-Society Consensus (TASC) A or B in 52.8% and TASC C and D in 47.2%. The overall primary patency estimate was 81% at 24 months. Primary patency significantly increased after 2005 (p=0.005). Cox regression analysis revealed only age as a significant predictor of sustained primary patency (HR 0.60, p<0.005). Any previous endovascular intervention (HR 2.52, p=0.02) was the main predictor for loss of secondary patency; history of cardiovascular disease (HR 0.27, p=0.04) was the main predictor of sustained secondary patency. Conclusion: The kissing stent technique has a good safety profile and acceptable patency rates up to 2 years, even in TASC C and D lesions, supporting an endovascular-first approach for AIOD.
format Online
Article
Text
id pubmed-6330696
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-63306962019-01-29 Meta-analysis of Individual Patient Data After Kissing Stent Treatment for Aortoiliac Occlusive Disease Groot Jebbink, Erik Holewijn, Suzanne Versluis, Michel Grimme, Frederike Hinnen, Jan Willem Sixt, Sebastian Angle, John F. Dorigo, Walter Reijnen, Michel M. P. J. J Endovasc Ther Lower Limb Interventions Purpose: To evaluate short- and long-term technical and clinical outcomes after kissing stent treatment of aortoiliac occlusive disease (AIOD) based on an individual participant data (IPD) meta-analysis. Materials and Methods: A search of the Scopus database identified 156 articles on KS treatment of AIOD; of these 22 met the inclusion criteria. Authors of 19 articles with contact information were approached to join an IPD consortium. Eight author groups responded and 5 provided anonymized data for merging into an IPD database. The number of included procedures was equal before and after 2005. The primary study outcome was the cumulative patency at 24 months. Secondary outcomes were patency at up to 60 months, complications, and changes in Rutherford category and ankle-brachial index. The predictive value of stent protrusion length, pre-/postdilation, stent type, and patient demographics on primary patency were examined with Cox proportional hazard modeling; outcomes are reported as the hazard ratio (HR). The Kaplan-Meier method was employed to estimate patency rates. Results: In total, 605 (40.9%) of 1480 patients presented in the literature were included in the IPD analysis. The indication for intervention was intermittent claudication in 84.2% and critical limb ischemia in 15.8%. Lesions were classified as TransAtlantic Inter-Society Consensus (TASC) A or B in 52.8% and TASC C and D in 47.2%. The overall primary patency estimate was 81% at 24 months. Primary patency significantly increased after 2005 (p=0.005). Cox regression analysis revealed only age as a significant predictor of sustained primary patency (HR 0.60, p<0.005). Any previous endovascular intervention (HR 2.52, p=0.02) was the main predictor for loss of secondary patency; history of cardiovascular disease (HR 0.27, p=0.04) was the main predictor of sustained secondary patency. Conclusion: The kissing stent technique has a good safety profile and acceptable patency rates up to 2 years, even in TASC C and D lesions, supporting an endovascular-first approach for AIOD. SAGE Publications 2018-11-30 2019-02 /pmc/articles/PMC6330696/ /pubmed/30499352 http://dx.doi.org/10.1177/1526602818810535 Text en © The Author(s) 2018 http://www.creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Lower Limb Interventions
Groot Jebbink, Erik
Holewijn, Suzanne
Versluis, Michel
Grimme, Frederike
Hinnen, Jan Willem
Sixt, Sebastian
Angle, John F.
Dorigo, Walter
Reijnen, Michel M. P. J.
Meta-analysis of Individual Patient Data After Kissing Stent Treatment for Aortoiliac Occlusive Disease
title Meta-analysis of Individual Patient Data After Kissing Stent Treatment for Aortoiliac Occlusive Disease
title_full Meta-analysis of Individual Patient Data After Kissing Stent Treatment for Aortoiliac Occlusive Disease
title_fullStr Meta-analysis of Individual Patient Data After Kissing Stent Treatment for Aortoiliac Occlusive Disease
title_full_unstemmed Meta-analysis of Individual Patient Data After Kissing Stent Treatment for Aortoiliac Occlusive Disease
title_short Meta-analysis of Individual Patient Data After Kissing Stent Treatment for Aortoiliac Occlusive Disease
title_sort meta-analysis of individual patient data after kissing stent treatment for aortoiliac occlusive disease
topic Lower Limb Interventions
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6330696/
https://www.ncbi.nlm.nih.gov/pubmed/30499352
http://dx.doi.org/10.1177/1526602818810535
work_keys_str_mv AT grootjebbinkerik metaanalysisofindividualpatientdataafterkissingstenttreatmentforaortoiliacocclusivedisease
AT holewijnsuzanne metaanalysisofindividualpatientdataafterkissingstenttreatmentforaortoiliacocclusivedisease
AT versluismichel metaanalysisofindividualpatientdataafterkissingstenttreatmentforaortoiliacocclusivedisease
AT grimmefrederike metaanalysisofindividualpatientdataafterkissingstenttreatmentforaortoiliacocclusivedisease
AT hinnenjanwillem metaanalysisofindividualpatientdataafterkissingstenttreatmentforaortoiliacocclusivedisease
AT sixtsebastian metaanalysisofindividualpatientdataafterkissingstenttreatmentforaortoiliacocclusivedisease
AT anglejohnf metaanalysisofindividualpatientdataafterkissingstenttreatmentforaortoiliacocclusivedisease
AT dorigowalter metaanalysisofindividualpatientdataafterkissingstenttreatmentforaortoiliacocclusivedisease
AT reijnenmichelmpj metaanalysisofindividualpatientdataafterkissingstenttreatmentforaortoiliacocclusivedisease