World Neurosurg
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Review Meta Analysis Comparative Study
Systematic and Comprehensive Comparison of Incidence of Restenosis between Carotid Endarterectomy and Carotid Artery Stenting in the Patients with Atherosclerotic Carotid Stenosis.
The purpose of the present study was to conduct a meta-analysis to systematically compare the incidence rates of in-stent restenosis after carotid artery stenting (CAS) and restenosis after carotid endarterectomy (CEA) for patients with atherosclerotic carotid stenosis. ⋯ Although CAS was preferred over CEA, regardless of restenosis >50% or >70% after revascularization within 1 year, no significant difference was observed with extension of the follow-up period to >1 year. CAS was not associated with a greater cumulative incidence of occlusion or the cumulative incidence of restenosis for symptomatic patients.
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Review Meta Analysis
Risk Factors for Restenosis Following Carotid Revascularization: a Meta-analysis of Hazard Ratios.
Carotid artery restenosis after carotid endarterectomy (CEA) or carotid artery stenting (CAS) will occur in 3%-30% of cases. Restenosis can lead to more frequent clinical and imaging monitoring and the potential for reoperation. We sought to define the demographic, clinical, and radiographic characteristics that influence the restenosis risk after carotid revascularization. ⋯ Diabetes, dyslipidemia, female gender, renal failure, hypertension, and smoking were associated with an increased risk of restenosis, and patch endarterectomy and symptomatic status at presentation were associated with a decreased risk of carotid restenosis. Both female gender and current smoking status were only associated with recurrent stenosis after CEA, and hypertension was only associated with restenosis after CAS.
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Review Meta Analysis
Cost Comparison of Surgical Clipping and Endovascular Coiling of Unruptured Intracranial Aneurysms - A Systematic Review.
Rupture of unruptured intracranial aneurysms (UIA) is the main cause for subarachnoid hemorrhage. UIA are widespread among the population. Advanced technology enables us to diagnose UIAs with increasing reliability and subsequently treat them. There are 2 main treatment options: surgical clipping and endovascular treatment of the aneurysm. This article aims to analyze costs of neurosurgical clipping and the endovascular approach to treat UIA, and to give an overview over the existing literature. ⋯ Due to different definitions of hospital costs and hardly reproducible calculations, comparability of the stated numbers is limited. Besides the economic impact, outcomes must be considered when making a treatment decision. The 2 treatment modalities are not equally suitable in every patient nor for every aneurysm location.