Drug-Eluting Stents Versus Conventional Endovascular Therapies in Symptomatic Infrapopliteal Peripheral Artery Disease: A Meta-analysis
Khalid Changal, Mitra Patel, Pratyush Pavan Devarasetty, Rachel Royfman, Spiro Veria, Rohit Vyas, Mohammed Mhanna, Neha Patel, Azizullah Beran, Mark W. Burket, Rajesh Gupta
Abstract
Background: Balloon angioplasty is the standard endovascular treatment for symptomatic infrapopliteal peripheral artery disease (PAD). However, recent trials have studied the effectiveness of drug-eluting stents (DES) for infrapopliteal PAD. Objective: This study investigated the use of DES compared with standard endovascular techniques for treatment of infrapopliteal artery disease. Methods: This is a comprehensive systematic review and meta-analysis of 9 recent randomized controlled trials. The primary clinical outcome assessed was primary patency. The secondary outcomes were target lesion revascularization (TLR), major limb amputation, and all-cause mortality. Results: = 11%). There was no statistical difference between DES versus control in rates of major limb amputation and mortality. Conclusions: DES have superior primary patency and TLR rates with no difference in amputation and all-cause mortality rates compared with conventional endovascular therapies in patients with infrapopliteal PAD.