MedStar Authors catalog › Details for: Comparison of treatment strategies for femoro-popliteal disease: A network meta-analysis.
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Comparison of treatment strategies for femoro-popliteal disease: A network meta-analysis.

by Koifman, Edward; Lipinski, Michael J; Buchanan, Kyle; Yu Kang, Won; Escarcega, Ricardo O; Waksman, Ron; Bernardo, Nelson L.
Citation: Catheterization & Cardiovascular Interventions. , 2018 Jan 14.Journal: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.Published: 2018ISSN: 1522-1946.Full author list: Koifman E; Lipinski MJ; Buchanan K; Yu Kang W; Escarcega RO; Waksman R; Bernardo NL.UI/PMID: 29332315.Subject(s): IN PROCESS -- NOT YET INDEXEDInstitution(s): MedStar Heart & Vascular InstituteActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access online Digital Object Identifier: (Click here) ORCID: Waksman, Ron (Click here) Abbreviated citation: Catheter Cardiovasc Interv. , 2018 Jan 14.Local Holdings: Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006.Abstract: OBJECTIVES: We sought to compare treatment strategies in a Bayesian network meta-analysis of randomized controlled trials.Abstract: BACKGROUND: Peripheral artery disease (PAD) is a prevalent morbidity that is treated with various strategies.Abstract: METHODS: We performed a MEDLINE search for randomized studies comparing at least 2 treatment strategies, including bypass surgery, percutaneous transluminal angioplasty (PTA) balloons, stents, covered stents, drug-eluting stents (DES), and drug-coated balloons (DCB), in patients with native femoro-popliteal disease. Mixed treatment comparison model generation was performed to directly and indirectly compare the strategies in terms of restenosis and target lesion revascularization (TLR) presented as odds ratios (OR, [95% credible intervals]).Abstract: RESULTS: Twenty-nine studies with 4,820 patients were included in the present study. PTA was the largest group with 1,900 patients, followed by DCB (n=1,343), bare metal stents (n=941), covered stents (n=304), DES (n=236), and bypass (n=92). Mean age was 68+/-9 years, 64% were male, 37% diabetic, and 55% smokers. Mean lesion length was 77+/-44 mm, and 39% were total occlusions. Bayesian hierarchical random-effects model demonstrated all treatments were significantly better than, or had a trend toward superiority over, PTA, with DCB ranking well in both restenosis (OR=0.29, [0.17-0.47]) and TLR (OR=0.31, [0.20-0.46]). Nonetheless, none of the therapies showed superiority in terms of survival or amputations.Abstract: CONCLUSION: Treatment of femoro-popliteal disease has significantly evolved in recent years, with higher rates of patency and freedom from TLR. However, the utility of these treatment strategies in terms of reduction of amputations and overall survival remains in question.Abstract: Copyright (c) 2018 Wiley Periodicals, Inc.

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