M. Hassan Murad, MD, MPH, David N. Flynn, BS, Mohamed B

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Presentation transcript:

Endarterectomy vs stenting for carotid artery stenosis: A systematic review and meta- analysis M. Hassan Murad, MD, MPH, David N. Flynn, BS, Mohamed B. Elamin, MBBS, Gordon H. Guyatt, MD, Robert W. Hobson, MD, Patricia J. Erwin, MLS, Victor M. Montori, MD, MSc Journal of Vascular Surgery Volume 48, Issue 2, Pages 487-493 (August 2008) DOI: 10.1016/j.jvs.2008.05.035 Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 1 Study selection. RCT, Randomized controlled trial. Journal of Vascular Surgery 2008 48, 487-493DOI: (10.1016/j.jvs.2008.05.035) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 2 Meta-analysis of 30-day risk of death associated with carotid angioplasty and stenting (CAS) and endarterectomy (CEA). Vertical line indicates no treatment effect, squares and horizontal lines indicate relative risks (RR) and associated 95% confidence intervals (CI) for each study, and diamonds indicate pooled relative risks. Three additional trials18,21,22 reported this outcome but had no events in either arm and did not contribute to the pooled estimate. Journal of Vascular Surgery 2008 48, 487-493DOI: (10.1016/j.jvs.2008.05.035) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 3 Meta-analysis of 30-day risk of nonfatal myocardial infarction (MI) associated with carotid angioplasty and stenting (CAS) and endarterectomy (CEA). Vertical line indicates no treatment effect, squares and horizontal lines indicate relative risks (RR) and associated 95% confidence intervals (CI) for each study, and diamonds indicate pooled relative risks. Four additional trials14,17,18,21 reported this outcome but had no events in either arm and did not contribute to the pooled estimate. Journal of Vascular Surgery 2008 48, 487-493DOI: (10.1016/j.jvs.2008.05.035) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 4 Meta-analysis of 30-day risk of any stroke associated with carotid artery angioplasty and stenting (CAS) and endarterectomy (CEA). Vertical line indicates no treatment effect, squares and horizontal lines indicate relative risks (RR) and associated 95% confidence intervals (CI) for each study, and diamonds indicate pooled relative risks. Two additional trials17,18 reported this outcome but had no events in either arm and did not contribute to the pooled estimate. Journal of Vascular Surgery 2008 48, 487-493DOI: (10.1016/j.jvs.2008.05.035) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 5 Equivalence analysis for 30-day outcomes for carotid angioplasty and stenting (CAS) and endarterectomy (CEA) using pooled risk difference percentages, 95% confidence intervals (CI), and theoretic equivalence margins. Journal of Vascular Surgery 2008 48, 487-493DOI: (10.1016/j.jvs.2008.05.035) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions