PT  - JOURNAL ARTICLE
AU  - Petr, O.
AU  - Brinjikji, W.
AU  - Murad, M.H.
AU  - Glodny, B.
AU  - Lanzino, G.
TI  - Selective-versus-Standard Poststent Dilation for Carotid Artery Disease: A Systematic Review and Meta-Analysis
AID  - 10.3174/ajnr.A5103
DP  - 2017 May 01
TA  - American Journal of Neuroradiology
PG  - 999--1005
VI  - 38
IP  - 5
4099  - http://www.ajnr.org/content/38/5/999.short
4100  - http://www.ajnr.org/content/38/5/999.full
SO  - Am. J. Neuroradiol.2017 May 01; 38
AB  - BACKROUND: The safety and efficacy of standard poststent angioplasty in patients undergoing carotid artery stent placement have not been well-established.PURPOSE: We conducted a systematic review of the literature to evaluate the safety and efficacy of carotid artery stent placement and analyzed outcomes of standard-versus-selective poststent angioplasty.DATA SOURCES: A systematic search of MEDLINE, EMBASE, Scopus, and the Web of Science was performed for studies published between January 2000 and January 2015.STUDY SELECTION: We included studies with >30 patients describing standard or selective poststent angioplasty during carotid artery stent placement.DATA ANALYSIS: A random-effects meta-analysis was used to pool the following outcomes: periprocedural stroke/TIA, procedure-related neurologic/cardiovascular morbidity/mortality, bradycardia/hypotension, long-term stroke at last follow-up, long-term primary patency, and technical success.DATA SYNTHESIS: We included 87 studies with 19,684 patients with 20,378 carotid artery stenoses. There was no difference in clinical (P = .49) or angiographic outcomes (P = .93) in carotid artery stent placement treatment with selective or standard poststent balloon angioplasty. Both selective and standard poststent angioplasty groups had a very high technical success of >98% and a low procedure-related mortality of 0.9%. There were no significant differences between both groups in the incidence of restenosis (P = .93) or procedure-related complications (P = .37).LIMITATIONS: No comparison to a patient group without poststent dilation could be performed.CONCLUSIONS: Our meta-analysis demonstrated no significant difference in angiographic and clinical outcomes among series that performed standard poststent angioplasty and those that performed poststent angioplasty in only select patients.CAScarotid artery stent placement