Endovascular vs. medical therapy in symptomatic vertebral artery stenosis: a meta-analysis |
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Authors: | Hongliang?Feng Yi?Xie Bin?Mei Yang?Liu Benlei?Li Changqing?Yin Tao?Wang Email author" target="_blank">Yumin?LiuEmail author |
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Institution: | 1.Department of Neurology,Zhongnan Hospital of Wuhan University,Wuhan,China;2.Department of Cardiology,Zhongnan Hospital of Wuhan University,Wuhan,China;3.Department of Laboratory Medicine,Zhongnan Hospital of Wuhan University,Wuhan,China |
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Abstract: | This meta-analysis aims to compare percutaneous transluminal angioplasty (PTA) to medical treatment (MT) for symptomatic vertebral artery stenosis (SVAS) treatment. We searched PubMed, Springer, Google Scholar, Clinical Trials, Cochrane Central, Chinese National Knowledge Infrastructure, and China Biological Medicine databases. All relevant comparative trials were included. All summary estimates were calculated by random-effect models. Ten comparative trials involving 672 patients were identified. Within 30-day follow-up, there was no significant difference between PTA plus MT and MT alone in vascular death, any stroke, posterior circulation TIA, posterior circulation infarction, and ischemic stroke (all P > 0.05). With a follow-up of more than 1 year, no significant difference was found between PTA plus MT and MT alone in all-cause death (3 vs. 7 %, P = 0.24), vascular death (4 vs. 7 %, P = 0.34), posterior circulation stroke (5 vs. 8 %, P = 0.48), posterior circulation ischemic events (8 vs. 25 %, P = 0.23), posterior circulation TIA (10 vs. 38 %, P = 0.11), posterior circulation infarction (6 vs. 12 %, P = 0.51), vertebral artery occlusion (6 vs. 12 %, P = 0.58), and in secondary long-term events, including any stroke, anterior circulation stroke, hemorrhagic stroke, and myocardial infarction (all P > 0.05), although PTA plus MT could largely reduce the vertebral artery stenosis rate MD 63.05 %, 95 % CI (32.77–93.34 %), P < 0.01]. Hence, PTA plus MT may be not superior to MT alone for SVAS treatment. Larger randomized trials are needed to verify the optimum therapy for SVAS. |
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