HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Muradin, G. S. R. Articles by Hunink, M. G. M. Search for Related Content PubMed PubMed Citation Articles by Muradin, G. S. R. Articles by Hunink, M. G. M.

Balloon Dilation and Stent Implantation for Treatment of Femoropopliteal Arterial Disease: Meta-Analysis¹

¹ From the Program for the Assessment of Radiological Technology (ART Program) and the Departments of Radiology (G.S.R.M., M.G.M.H.) and Epidemiology and Biostatistics (G.S.R.M., J.L.B., T.S., M.G.M.H.), Erasmus University Medical Center Rotterdam, Dr Molewaterplein 50, Rm EE21-40a, 3015 GE Rotterdam, the Netherlands; Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (J.L.B.); and Department of Health Policy and Management, Harvard School of Public Health, Boston, Mass (M.G.M.H.). From the 2000 RSNA scientific assembly. Received November 28, 2000; revision requested January 24, 2001; revision received April 4; accepted April 9. Address correspondence to M.G.M.H. (e-mail: hunink@epib.fgg.eur.nl).

PURPOSE: To perform a meta-analysis of long-term results of balloon dilation and stent implantation in the treatment of femoropopliteal arterial disease.

MATERIALS AND METHODS: The English-language literature was searched for studies published between 1993 and 2000. Inclusion criteria for articles were presentation of long-term primary patency rates, standard errors (explicitly reported or derivable), and baseline characteristics of the study population. Two reviewers independently extracted data, and discrepancies were resolved by consensus. Primary patency rates were combined by using a technique that allows adjustment for differences across study populations. Analyses were adjusted for lesion type and clinical indication.

RESULTS: Nineteen studies met the inclusion criteria, representing 923 balloon dilations and 473 stent implantations. Combined 3-year patency rates after balloon dilation were 61% (standard error, 2.2%) for stenoses and claudication, 48% (standard error, 3.3%) for occlusions and claudication, 43% (standard error, 4.1%) for stenoses and critical ischemia, and 30% (standard error, 3.7%) for occlusions and critical ischemia. The 3-year patency rates after stent implantation were 63%–66% (standard error, 4.1%) and were independent of clinical indication and lesion type. Funnel plots demonstrated an asymmetric distribution of the data points associated with stent studies.

CONCLUSION: Balloon dilation and stent implantation for claudication and stenosis yield similar long-term patency rates. For more severe femoropopliteal disease, the results of stent implantation seem more favorable. Publication bias could not be ruled out.

Index terms: Arteries, femoral • Arteries, grafts and prostheses, 921.1268, 924.1268 • Arteries, popliteal • Arteries, stenosis or obstruction, 921.721, 924.721 • Arteries, transluminal angioplasty, 921.1282, 921.1286, 924.1282, 924.1286 • Radiology and radiologists, outcomes studies • Stents and prostheses, 921.1282, 921.1286, 924.1282, 924.1286

This article has been cited by other articles:

				C. Kasapis, P. K. Henke, S. J. Chetcuti, G. C. Koenig, J. E. Rectenwald, V. N. Krishnamurthy, P. M. Grossman, and H. S. Gurm Routine stent implantation vs. percutaneous transluminal angioplasty in femoropopliteal artery disease: a meta-analysis of randomized controlled trials Eur. Heart J., January 1, 2009; 30(1): 44 - 55. [Abstract] [Full Text] [PDF]

				S. A Arain and C. J White Endovascular therapy for critical limb ischemia Vascular Medicine, August 1, 2008; 13(3): 267 - 279. [Abstract] [PDF]

				E. H. Murphy and F. R. Arko Karthik S, et al. Cryoplasty for Arterial Restenosis. Eur J Vasc Endovasc Surg. 2007;33:40-43 Perspectives in Vascular Surgery and Endovascular Therapy, March 1, 2008; 20(1): 98 - 100. [Abstract] [PDF]

				C. J. White and W. A. Gray Endovascular Therapies for Peripheral Arterial Disease: An Evidence-Based Review Circulation, November 6, 2007; 116(19): 2203 - 2215. [Abstract] [Full Text] [PDF]

				E. L. Chaikof and J. Y. Wang Commentary on "Biological Treatment of Vein Grafts and Stents in Lower-Extremity Arterial Reconstruction" Perspectives in Vascular Surgery and Endovascular Therapy, September 1, 2007; 19(3): 298 - 299. [PDF]

				C. White Intermittent Claudication N. Engl. J. Med., March 22, 2007; 356(12): 1241 - 1250. [Full Text] [PDF]

				R. H. Samson, D. P. Showalter, M. R. Lepore Jr, and S. Ames CryoPlasty Therapy of the Superficial Femoral and Popliteal Arteries: A Single Center Experience Vascular and Endovascular Surgery, January 1, 2007; 40(6): 446 - 450. [Abstract] [PDF]

				C. Klonaris, A. Katsargyris, A. Giannopoulos, and E. Bastounis Advances in Endovascular Treatment of Femoropopliteal Arterial Occlusive Disease Perspectives in Vascular Surgery and Endovascular Therapy, December 1, 2006; 18(4): 329 - 341. [Abstract] [PDF]

				U. Speck, B. Scheller, C. Abramjuk, C. Breitwieser, J. Dobberstein, M. Boehm, and B. Hamm Neointima Inhibition: Comparison of Effectiveness of Non-Stent-based Local Drug Delivery and a Drug-eluting Stent in Porcine Coronary Arteries. Radiology, August 1, 2006; 240(2): 411 - 418. [Abstract] [Full Text] [PDF]

				A. T. Hirsch Treatment of peripheral arterial disease--extending "intervention" to "therapeutic choice". N. Engl. J. Med., May 4, 2006; 354(18): 1944 - 1947. [Full Text] [PDF]

				S. Spronk, J. L. Bosch, H. F. Veen, P. T. den Hoed, and M. G. M. Hunink Intermittent Claudication: Functional Capacity and Quality of Life after Exercise Training or Percutaneous Transluminal Angioplasty--Systematic Review Radiology, June 1, 2005; 235(3): 833 - 842. [Abstract] [Full Text] [PDF]

				E. Minar, M. Schillinger, K. Krueger, and K. Lackner Endovascular Irradiation after Femoropopliteal Angioplasty * Drs Krueger and Lackner respond: Radiology, December 1, 2004; 233(3): 935 - 937. [Full Text] [PDF]

				M. A. Mauro The Battle of Intimal Hyperplasia in the War against Femoropopliteal Disease Radiology, May 1, 2004; 231(2): 299 - 301. [Full Text] [PDF]

				T. W. I. Clark, G. S. R. Muradin, and M. G. Myriam Hunink Stent Placement in Femoropopliteal Arteries * Drs Muradin and Hunink respond: Radiology, July 1, 2002; 224(1): 297 - 297. [Full Text]