Comparison of Thromboembolic Complications After Carotid Artery Stenting with and without Using Protection Devices: A Systematic Review and Meta-Analysis Study

Authors

  • Maryam Sadr Dr. Kiani Imaging Center, Tehran, Iran
  • Kimia Vakili Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Dorsa Bahrami Zanjanbar Pharmaceutical Science Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran and GI Pharmacology Interest Group (GPIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
  • Fatemeh Hasani Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
  • Mohammad Samadian Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Reza Madadi Department of Cardiology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
  • Arian Tavasol Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Atoosa Keshavarzmotamed Student Research Committee, Guilan University of Medical Sciences, Rasht, Iran
  • Omidvar Rezaei Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Seyed Ali Mousavinejad Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

DOI:

https://doi.org/10.26676/jevtm.25894

Keywords:

Carotid Angioplasty, Carotid Artery Stenting, Protection Devices, Thromboembolic

Abstract

Background: This study compared the rate of thromboembolic events during carotid angioplasty and stenting (CAS)  with and without embolic protection devices (EPDs). We reviewed literature to find studies comparing embolic event rates during CAS with and without EPDs and conducted a meta-analysis to determine the safer approach.
Methods: The Embase, PubMed, and Web of Science databases were thoroughly searched following PRISMA guidelines. Each estimation was executed using random-effects models. The I2 index was used to assess the heterogeneity among the studies. Egger and Begg’s tests were applied to evaluate publication bias. Stata version 14.2 was used for statistical analysis.
Results: For 25% of patients, an EPD was used during CAS, and for 75% it was not. Of the patients undergoing CAS, the prevalences of hypertension, diabetes mellitus, coronary artery disease, and cigarette smoking were 81%, 37%, 39% and 43%, respectively. In total, of the patients included 52% were symptomatic and 48% were asymptomatic. The mortality rate reduced from 2% in the no-EPD subgroup to 1% in the EPD subgroup. The occurrence of all other complications was also reportedly higher in patients who did not receive an EPD, including major stroke and myocardial infarction, except for minor events, which were reported to be almost the same in both subgroups.
Conclusions: We found that the use of an EPD can help reduce the occurrence of thromboembolic complications of CAS, including myocardial infarction, major stroke, and death. Altogether, our results suggest that the benefits of using an EPD during CAS outweigh its risks.

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Published

2024-10-11

How to Cite

Sadr, M., Vakili, K., Bahrami Zanjanbar, D., Hasani, F., Samadian, M., Madadi, R., … Ali Mousavinejad, S. (2024). Comparison of Thromboembolic Complications After Carotid Artery Stenting with and without Using Protection Devices: A Systematic Review and Meta-Analysis Study. Journal of Endovascular Resuscitation and Trauma Management, 8(2). https://doi.org/10.26676/jevtm.25894

Issue

Section

Systemic Reviews and Meta-Analyses

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