对比Viabahn覆膜支架与金属裸支架治疗股腘动脉硬化闭塞症效果:Meta分析

Comparison on efficacy of Viabahn covered stent and bare metal stent for treatment of femoropopliteal arteriosclerosis obliterans:Meta-analysis

目的采用meta分析方法对比Viabahn覆膜支架与金属裸支架(BMS)治疗股腘动脉硬化闭塞症(ASO)的效果。方法检索筛选中国生物医学文献数据库、万方医学网、中国知网、Embase、Web of Science、Cochrane Library和PubMed数据库关于以Viabahn覆膜支架(Viabahn组)及BMS(BMS组)治疗股腘ASO的随机对照研究,检索时间为建库至2022年4月30日;依据纳入及排除标准筛选文献。采用Cochrane RevMan 5.3软件分析组间技术成功率、12个月一/二期通畅率、靶病变血管重建(TLR)率和/或截肢率。结果最终纳入9篇文献,含Viabahn组424例、BMS组469例共893例患者。Viabahn组12个月一期通畅率高于BMS组[比值比(OR)=1.90,95%CI(1.23,2.92),P=0.004],而其TLR率低于BMS组[OR=0.44,95%CI(0.26,0.76),P=0.003],组间技术成功率[风险差异(RD)=0,95%CI(-0.01,0.02),P=0.59]、12个月二期通畅率[OR=1.48,95%CI(0.96,2.29),P=0.07]及截肢率[RD=0,95%CI(-0.02,0.03),P=0.79]差异均无统计学意义。结论Viabahn覆膜支架及BMS用于治疗股腘动脉ASO可提高12个月一期通畅率、降低TLR率,二者12个月二期通畅率及截肢率相当。

Objective To compare the efficacy of Viabahn covered stent and bare metal stent(BMS)in treatment of femoropopliteal arteriosclerosis obliterans(ASO)using meta-analysis.Methods Randomized controlled studies of Viabahn covered stent(Viabahn group)and BMS(BMS group)in treatment of femoropopliteal ASO were searched in China Biology Medicine disc(CBMdisc),Wanfang Med Online,CNKI,Embase,Web of Science,Cochrane Library and PubMed from establishment to April 30,2022.Then the literature were screened according to inclusion and exclusion criterias.Cochrane RevMan 5.3 software was used to analyze the technical success rate,12-month primary/secondary patency rate,target lesion revascularization(TLR)rate and/or amputation rate between groups.Results Nine articles were enrolled,including 893 patients,424 in Viabahn group and 469 in BMS group,respectively.The 12-month primary patency rate in Viabahn group was higher than that in BMS group(odds ratio[OR]=1.90,95%CI[1.23,2.92],P=0.004),and the TLR rate in Viabahn group was lower than that in BMS group(OR=0.44,95%CI[0.26,0.76],P=0.003).No significant difference of technical success rate(risk difference[RD]=0,95%CI[-0.01,0.02],P=0.59),12-month secondary patency rate(OR=1.48,95%CI[0.96,2.29],P=0.07)nor amputation rate(RD=0,95%CI[-0.02,0.03],P=0.79)was found between groups.Conclusion Both Viabahn covered stent and BMS could increase the 12-month primary patency rate and reduce the TLR rate in treatment of femoropopliteal ASO,with matches 12-month secondary patency rates and amputation rates.