Randomized Trials for Endovascular Treatment of Infrainguinal Arterial Disease: Systematic Review and Meta-analysis (Part 1: Above the Knee)

Jens, Sjoerd; Conijn, A.P.; Koelemay, M.J.W.; Bipat, Shandra; Reekers, Jim A.

doi:10.1016/j.ejvs.2014.02.011

Cited by 41 publications

(18 citation statements)

References 39 publications

(23 reference statements)

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“…Updated data on the clinical effectiveness of endovascular interventions were initially taken from the systematic review and meta-analysis of Jens et al 10. The searches for this review were conducted in November 2013.…”

Section: Methodsmentioning

confidence: 99%

“…As this was the only evidence about biomimetic stents that the authors were aware of, this study considered the cost-effectiveness of the BioMimics 3D stent with the assumption that this was representative of the class of biomimetic stents. For DESs, only one publication7 was included in Jens et al 10. More recent data from this study (with longer follow-up) have been published 11.…”

Section: Methodsmentioning

confidence: 99%

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Cost-effectiveness of superficial femoral artery endovascular interventions in the UK and Germany: a modelling study

Kearns

Thomas

2017

BMJ Open

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ObjectivesTo assess the lifetime costs and cost-effectiveness of 5 endovascular interventions to treat superficial femoral arterial disease.DesignA model-based health economic evaluation. An existing decision analytical model was used, with updated effectiveness data taken from the literature, and updated costs based on purchasing prices.SettingUK and German healthcare perspectives were considered.ParticipantsPatients with intermittent claudication of the femoropopliteal arteries eligible for endovascular treatment.MethodsUK and German healthcare perspectives were considered, as were different strategies for re-intervention.InterventionsPercutaneous transluminal angioplasty (PTA) with bail-out bare metal stenting (assumed to represent the existing standard of care, and 4 alternatives: primary bare metal stents, drug-eluting stents, drug-eluting balloons (DEBs) and biomimetic stents).Primary outcome measuresThe incremental cost-effectiveness ratio between 2 treatments, defined as the incremental costs divided by the incremental quality-adjusted life years (QALYs).ResultsUse of a biomimetic stent, BioMimics 3D, was always estimated to dominate the other interventions, having lower lifetime costs and greater effectiveness, as measured by QALYs. Of the remaining interventions, DEBs were always the most effective, and PTA the least effective. There was uncertainty in the cost-effectiveness results, with key drivers being the costs and effectiveness of the biomimetic stent along with the costs of DEBs.ConclusionsAll 4 of the alternatives to PTA were more effective, with the biomimetic stent being the most cost-effective. As there was uncertainty in the results, and all of the interventions have different mechanisms of action, all 4 may be considered to be alternatives to PTA.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Cost-effectiveness of superficial femoral artery endovascular interventions in the UK and Germany: a modelling study

Kearns

Thomas

2017

BMJ Open

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“…Uzun dönem açıklık oranını artırmak amaçlı ideal yöntem ve malzeme arayışı devam etmektedir. Standart strateji önce anjiyoplasti gerekirse stentleme yapılmasıdır [16]. Kronik uzun segment tıkanıklık ve darlıklarda stent öncelikle tercih edilebilir.…”

Section: Alt Ekstremite Periferik Arter Hastalıklarında Anjiyoplasti/unclassified

“…Standart endovaskü-ler yaklaşıma ek olarak, ilaçlı balon ve stentler, kaplı stentler, eriyebilir stentler, aterektomi, kriyoplasti gibi yöntemler denenmekte sonuç-ları standart yaklaşımla karşılaştırılmaktadır. Şu anki veriler femoropopliteal lezyonlarda endikasyon farkı gözetmeden (kladikasyon veya kritik bacak iskemisi) balon anjiyoplasti ile birlikte gerektiğinde stentleme yönteminin en geçerli yaklaşım olduğunu gösteriyor [16]. İlaçlı balon ve stentlerde erken dönem (6-12 ay) açıklık yüzdeleri standart anjiyoplasti ve stentlere göre daha iyidir.…”

Section: Alt Ekstremite Periferik Arter Hastalıklarında Anjiyoplasti/unclassified

Anjioplasti/Stentleme: Etki Mekanizmasi ve Temel Uygulamalar

Erdoğan¹,

Kaya²

2015

Trd Sem

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“…Subintimal angioplasty or other adjunctive techniques, including atherectomy and reentry devices, can be utilized to help with initial recanalization of the occluded vessels. Other newer techniques such as self-expanding stents, stent grafts, cutting balloons, and drug-eluting balloons and stents are increasingly used to enhance the effectiveness of PTA, though data available for these promising new technologies are limited 27,37,38…”

Section: Endovascular Therapymentioning

confidence: 99%

Optimal management of infrainguinal arterial occlusive disease

Pennywell¹,

Tan²,

Zhang³

2014

VHRM

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Peripheral arterial occlusive disease is becoming a major health problem in Western societies as the population continues to age. In addition to risk of limb loss, the complexity of the disease is magnified by its intimate association with medical comorbidity, especially cardiovascular and cerebrovascular disease. Risk factor modification and antiplatelet therapy are essential to improve long-term survival. Surgical intervention is indicated for intermittent claudication when a patient’s quality of life remains unacceptable after a trial of conservative therapy. Open reconstruction and endovascular revascularization are cornerstone for limb salvage in patients with critical limb ischemia. Recent advances in catheter-based technology have made endovascular intervention the preferred treatment approach for infrainguinal disease in many cases. Nevertheless, lower extremity bypass remains an important treatment strategy, especially for reasonable risk patients with a suitable bypass conduit. In this review, we present a summary of current knowledge about peripheral arterial disease followed by a review of current, evidence-based medical and surgical therapy for infrainguinal arterial occlusive disease.

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Randomized Trials for Endovascular Treatment of Infrainguinal Arterial Disease: Systematic Review and Meta-analysis (Part 1: Above the Knee)

Abstract: In general, performing PTA with optional bailout stenting for ATK lesions is the preferred strategy in patients with IC. For CLI, more studies are needed for recommending an optimal treatment strategy.

Cited by 41 publications

References 39 publications

Cost-effectiveness of superficial femoral artery endovascular interventions in the UK and Germany: a modelling study

Cost-effectiveness of superficial femoral artery endovascular interventions in the UK and Germany: a modelling study

Anjioplasti/Stentleme: Etki Mekanizmasi ve Temel Uygulamalar

Optimal management of infrainguinal arterial occlusive disease

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