Do Study Results Translate Into Practice? Intracranial Stenting in Germany

Schillinger, Gerhard; Hagenmeyer, Ernst-Günther; Pritzkau, Andreas; Friedrich, Jörg

doi:10.1017/s0266462317000411

Cited by 2 publications

(1 citation statement)

References 10 publications

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“…The results of the SAMMPRIS trial and the Vitesse Intracranial Stent Study for Ischemic Stroke Therapy (VISSIT) trial supported the use of medical management alone as being superior to stenting plus medical management [ 15 , 16 ]. There were few indications changed for stenting in cases of intracranial atherosclerosis stenosis [ 17 ]. However, studies from other authors indicated promising outcomes for stent therapy.…”

Section: Introductionmentioning

confidence: 99%

Comparative effect of stenting plus medical therapy vs medical therapy alone on the risk of stroke and death in patients with symptomatic intracranial stenosis: a systematic review and meta-analysis

Wang

et al. 2022

J Neurol

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Background Recently, several randomized controlled trials (RCTs) of stenting plus medical therapy versus medical therapy alone have been successfully conducted for the treatment of patients with symptomatic intracranial stenosis. This study aimed to evaluate differences between these two therapies in the risk of stroke and death. Methods MEDLINE, EMBASE, the Cochrane Library, and ClinicalTrials.gov were systematically searched to identify relevant studies published before August 24, 2022. Review Manager 5.3 software was used to assess the data. The risk ratio (RR) was analysed and calculated with a random effect model or a fixed effects model. Results We pooled 921 participants from three RCTs. Compared to the medical therapy alone group, the stenting plus medical therapy group had a higher risk of 30-day death or stroke (RR = 2.69 [1.64–4.41], P < 0.0001, I2 = 0%). When the follow-up period exceeded 1 year (≥ 1 year), there was no significant difference in the risk of stroke or death between these two groups. The subgroup analysis showed that if the time from stroke onset to implantation was extended, additional stenting would have no effect on the risk of stroke or death, whether within 30 days or within 1 year (P = 0.16 and 0.78). Conclusion Medical therapy alone has a lower risk of stroke and death in the short term than stenting plus medical therapy, while no difference exists in the long term. More studies are still needed to further explore the precision strategy of stent implantation for symptomatic intracranial stenosis patients.

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Section: Introductionmentioning

confidence: 99%