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Verzini F. In the endless search of the holy grail of "level 1 evidence". THE JOURNAL OF CARDIOVASCULAR SURGERY 2024; 65:179-180. [PMID: 39007551 DOI: 10.23736/s0021-9509.24.13102-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Affiliation(s)
- Fabio Verzini
- Unit of Vascular Surgery, Department of Surgical Sciences, Città della Salute e della Scienza di Torino University Hospital, University of Turin, Turin, Italy -
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Tigkiropoulos K, Nikas S, Ampatzis-Papadopoulos M, Sidiropoulou K, Stavridis K, Karamanos D, Lazaridis I, Saratzis N. One-Year Outcomes of CGuard Double Mesh Stent in Carotid Artery Disease: A Systematic Review and Meta-Analysis. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:286. [PMID: 38399573 PMCID: PMC10890088 DOI: 10.3390/medicina60020286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/02/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024]
Abstract
Background: Prospective single and multicenter studies have shown improved outcomes of patients who underwent carotid artery stenting with the novel CGuard dual-layer mesh stent at 1 year. Objectives: The aim of this study is to conduct a systematic review and meta-analysis of all published studies to assess 1-year efficacy and outcomes of CGuard in patients with carotid stenting. Methods: A systematic search was performed. All studies enrolling at least 20 patients were included in our analysis. The primary endpoints were death (all-cause, cardiovascular and ipsilateral stroke-related death) and stroke rate at 1 year. The secondary endpoint was in-stent restenosis at 1 year. Results: The final analysis included 1709 patients. The one-year all-cause mortality rate was 2.97% (39/1699, 95% CI: 1.26-6.86%, I2 = 67%, t2 = 0.3442, p < 0.01), cardiovascular-related death was 0.92% (10/1616, 95% CI: 0.35-2.39%, I2 = 34%, t2 = 0.2302, p = 0.18), and ipsilateral stroke-related death was 0.3% (1/1649, 95% CI: 0.1-0.87%, I2 = 0%, t2 = 0, p = 0.69). The one-year ipsilateral stroke rate was 1.21% (16/1649, 95% CI: 0.58-2.5%, I2 = 28%, t2 = 0.1433, p = 0.23), transient ischemic attacks (TIAs) rate was 1.78% (19/1149, 95% CI: 1.11-2.84%, I2 = 0%, t2 = 0, p = 0.69), and total composite 1-year stroke/TIA rate was 2.97% (32/1149, 95% CI: 1.84-4.77%, I2 = 0%, t2 = 0, p = 0.41). The in-stent restenosis rate at 1 year was 1.06% (13/1653, 95% CI: 0.48-2.34%, I2 = 28%, t2 = 0.2308, p = 0.22). Conclusions: This meta-analysis shows that CAS with CGuard is safe with minimal neurological adverse events and in-stent restenosis rate at 1 year.
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Affiliation(s)
- Konstantinos Tigkiropoulos
- Division of Vascular Surgery, 1st Surgical Department, Faculty of Health Sciences, Papageorgiou General Hospital, Aristotle University, 56403 Thessaloniki, Greece
| | - Spyridon Nikas
- Department of Radiology, Papageorgiou General Hospital, 56403 Thessaloniki, Greece
| | - Manolis Ampatzis-Papadopoulos
- Division of Vascular Surgery, 1st Surgical Department, Faculty of Health Sciences, Papageorgiou General Hospital, Aristotle University, 56403 Thessaloniki, Greece
| | - Katerina Sidiropoulou
- Division of Vascular Surgery, 1st Surgical Department, Faculty of Health Sciences, Papageorgiou General Hospital, Aristotle University, 56403 Thessaloniki, Greece
| | - Kyriakos Stavridis
- Division of Vascular Surgery, 1st Surgical Department, Faculty of Health Sciences, Papageorgiou General Hospital, Aristotle University, 56403 Thessaloniki, Greece
| | - Dimitrios Karamanos
- Division of Vascular Surgery, 1st Surgical Department, Faculty of Health Sciences, Papageorgiou General Hospital, Aristotle University, 56403 Thessaloniki, Greece
| | - Ioannis Lazaridis
- Division of Vascular Surgery, 1st Surgical Department, Faculty of Health Sciences, Papageorgiou General Hospital, Aristotle University, 56403 Thessaloniki, Greece
| | - Nikolaos Saratzis
- Division of Vascular Surgery, 1st Surgical Department, Faculty of Health Sciences, Papageorgiou General Hospital, Aristotle University, 56403 Thessaloniki, Greece
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Musialek P, Langhoff R, Stefanini M, Gray WA. Carotid stent as cerebral protector: the arrival of Godot. THE JOURNAL OF CARDIOVASCULAR SURGERY 2023; 64:555-560. [PMID: 38385839 DOI: 10.23736/s0021-9509.23.12956-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Affiliation(s)
- Piotr Musialek
- Department of Cardiac and Vascular Diseases, Jagiellonian University, Krakow, Poland -
- St. John Paul II Hospital, Stroke Thrombectomy-Capable Center, Krakow, Poland -
| | - Ralf Langhoff
- Department of Angiology, Sankt-Gertrauden Hospital, Academic Teaching Hospital of Charité University, Berlin, Germany
| | - Matteo Stefanini
- Department of Radiology and Interventional Radiology, Casilino Hospital, Rome, Italy
| | - William A Gray
- Main Line Health, Wynnewood, PA, USA
- Sidney Kimmel School of Medicine, Thomas Jefferson University, Philadelphia, PA, USA
- Lankenau Heart Institute, Wynnewood, PA, USA
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