High- Versus Low-Dose Paclitaxel-Coated Balloons for Femoropopliteal Disease: A systematic review and meta-analysis.

IF 2 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Cardiology in Review Pub Date : 2024-09-10 DOI:10.1097/CRD.0000000000000771
Gan Jin, Zhaokun Sun, Chunjiang Liu, Miaojun Xu
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Abstract

To evaluate the comparative effectiveness of high- and low doses of paclitaxel in endovascular revascularization procedures for patients with femoropopliteal disease. The databases (Embase, PubMed, Scopus, and Web of Science) were searched for studies that had compared outcomes of high-dose and low-dose paclitaxel-coated balloons (PCBs) in the treatment of patients with femoropopliteal disease. Randomized controlled trials and nonrandomized comparative studies (eg, cohort studies and case-control studies) were eligible for inclusion. The primary outcomes of interest were patency rates, risk of restenosis, and clinically-driven target lesion revascularization (CD-TLR). Pooled effect sizes were reported as relative risk (RR) with 95% confidence intervals (CI). The analysis included 7 studies. High-dose PCB use was associated with higher patency (RR, 1.10; 95% CI, 1.00-1.21), reduced risk of restenosis (RR, 0.60; 95% CI, 0.46-0.79), and reduced need for CT-TLR (RR, 0.57; 95% CI, 0.41-0.79) compared to low-dose PCB. Rates of limb salvage (RR, 1.01; 95% CI, 0.99-1.04), freedom from major adverse limb events (RR, 1.39; 95% CI, 0.79-2.42), and overall survival (RR, 1.02; 95% CI, 0.99-1.05) were comparable in the 2 groups. There was no evidence of publication bias. High-dose PCB correlates with superior outcomes in patients with femoropopliteal disease, particularly in terms of better vascular patency, reduced restenosis risk, and lower need for target lesion revascularization, compared to low-dose PCB.

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高剂量与低剂量紫杉醇涂层球囊治疗股骨头疾病:系统回顾和荟萃分析。
目的:评估高剂量和低剂量紫杉醇在股骨头坏死患者血管内再通手术中的疗效比较。我们在数据库(Embase、PubMed、Scopus 和 Web of Science)中搜索了在治疗股骨头疾病患者时比较高剂量和低剂量紫杉醇涂层球囊(PCBs)疗效的研究。随机对照试验和非随机对照研究(如队列研究和病例对照研究)均符合纳入条件。主要研究结果包括通畅率、再狭窄风险和临床驱动的靶病变血运重建(CD-TLR)。汇总效应大小以相对风险 (RR) 和 95% 置信区间 (CI) 的形式报告。分析包括 7 项研究。与低剂量多氯联苯相比,高剂量多氯联苯与更高的通畅率(RR,1.10;95% CI,1.00-1.21)、更低的再狭窄风险(RR,0.60;95% CI,0.46-0.79)和更低的 CT-TLR 需求(RR,0.57;95% CI,0.41-0.79)相关。两组的肢体挽救率(RR,1.01;95% CI,0.99-1.04)、肢体无重大不良事件发生率(RR,1.39;95% CI,0.79-2.42)和总生存率(RR,1.02;95% CI,0.99-1.05)相当。没有证据表明存在发表偏倚。与低剂量多氯联苯相比,高剂量多氯联苯对股骨头疾病患者的疗效更佳,尤其是在血管通畅性、再狭窄风险降低以及靶病变血运重建需求降低等方面。
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来源期刊
Cardiology in Review
Cardiology in Review CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
4.60
自引率
0.00%
发文量
76
审稿时长
>12 weeks
期刊介绍: The mission of Cardiology in Review is to publish reviews on topics of current interest in cardiology that will foster increased understanding of the pathogenesis, diagnosis, clinical course, prevention, and treatment of cardiovascular disorders. Articles of the highest quality are written by authorities in the field and published promptly in a readable format with visual appeal
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