同期与分期支架成形术治疗双侧颈动脉狭窄疗效比较的Meta分析

Meta-analysis of clinical efficacy following simultaneous comparing staged bilateral carotid stenting for treating patients with bilateral carotid stenosis

目的:通过Meta分析,探讨对于双侧颈动脉狭窄病变,同期双侧颈动脉支架成形术(BCAS)与分期双侧颈动脉支架成形术治疗的疗效差异。方法:通过检索Cochrane Library、Pubmed、Embase及中国期刊全文数据库(CNKI)筛选与双侧颈动脉狭窄同期或分期支架治疗的相关文献,进行Meta分析对比同期BCAS与分期BCAS术后血流动力学抑制、高灌注综合征以及术后30d内主要结局事件有无差异。结果:共有6篇文献入选,6项研究总样本量为244,其中同期BCAS组样本量为127,分期BCAS组样本量为117。两组术后血流动力学抑制、高灌注综合征以及术后30d内主要结局事件均差异无统计学意义(OR=1.41,95%CI:0.51~3.86;OR=2.81,5%CI:0.89~8.89;OR=1.01,95%CI:0.42~2.39)。结论:对于双侧颈动脉狭窄病变,同期BCAS疗效与分期BCAS并无差异,可以将同期BCAS作为治疗双侧颈动脉狭窄病变的有效策略。

Objective：To explore clinical efficacy following simultaneous comparing staged bilateral carotid stenting in the patients with bilateral carotid stenosis through Meta-analysis.Methods：Using the Cochrane Library,Pubmed,Embase,and CNKI,we reviewed all RCTs and observational studies examining the impact of simultaneous or staged BCAS in treating patients with bilateral carotid stenosis,which consist of hemodynamic depression,hyperperfusion syndrome and 30 days outcomes.We searched for literature published before April 2017 and earlier.Results：A total of six studies were identified including 244 patients with bilateral carotid stenosis who underwent Simuhaneous BCAS （n =127） and Staged BCAS（n =117）.There was no significant differences in hemodynamic depression,hyperperfusion syndrome and 30 days outcomes between two groups（OR =1.41,95% CI：0.51 ～ 3.86;OR =2.81,95% CI：0.89 ～.8.89） and（OR =1.01,95% CI：0.42 ～2.39）.Conclusion：Simultaneous BCAS is as safe and effective as staged BCAS,and can be regarded as an alternative strategy.