O-007 Carotid stent cell design modified the periprocedural outcomes in the stenting arm of randomized trials of carotid revascularization: a meta-analysis: Abstract O-007 Figure 1
Notice bibliographique
Résumé
Introduction Trials describe a risk of stroke of about 6% following carotid artery stenting (CAS). Stent cell design has been implicated as a potential factor in these risks. The small free cell area between the struts of a closed-cell stent theoretically provides better scaffolding of the vessel wall and superior plaque stabilization compared to the larger uncovered gaps in open-cell stents. No comparison between stent designs, and their relative effects on clinical outcome compared with carotid endarterectomy, has yet been published in the literature. Materials and Methods This is an exploratory meta-analysis of randomized control trials (RCTs) comparing carotid endarterectomy (CEA) to CAS stratified by the stent cell design. A comprehensive literature search was conducted on major scholar search engines until July 2010. The primary outcome was a composite of the 30-day risk of stroke or death. A Mantel-Hansel random-effects model was used to calculate OR and 95% CIs. Results Nine RCTs (4949 patients) were included in the final analysis. Closed-cell stent design was used in 807 patients and open-cell stents in 1657 patients, while 2485 patients were treated with CEA. The primary outcome was significantly lower in the CEA arm compared to CAS using open-cell design arm (OR 1.84, 95% CI 1.23 to 2.75; p=0.003). However, there was no significant difference in the primary outcome between CEA and CAS using closed-cell design, although a trend favoring CEA was noted (OR 1.54; 95% CI 0.69 to 3.47; p=0.29), Abstract O-007 figure 1. If only the 30-day stroke rate was considered, the difference between CEA and CAS in the closed-cell stents is still non-significant (OR 2.92; 95% CI 0.52 to 16.21; p=0.22), compared to open-cell stents which continued to be inferior to CEA (OR 1.97; 95% CI 1.33 to 2.92; p=0.0007). Abstract O-007 Figure 1 (A) Periprocedural stroke or death with CEA vsOpen-cell stents. (B) Periprocedural stroke or death with CEA vsClosed-cell stents. Conclusion In this meta-analysis of nine RCTs, CEA was not superior to CAS in trials using closed-cell stents. While these results may suggest better outcomes of CAS using the closed-cell stents, trials included in this analysis did not randomize patients to open- vs closed-cell stents. Furthermore, trials using the closed design recruited fewer patients than those using open-cell stents. Further assessment of a potential modification of CAS outcomes by stent design is underway with a meta-analysis of prospective CAS cohorts and registries to directly compare open- vs closed-cell stents. Competing interests None.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,019 | 0,044 |
| Méta-épidémiologie (sens strict) | 0,003 | 0,001 |
| Méta-épidémiologie (sens large) | 0,012 | 0,049 |
| Bibliométrie | 0,003 | 0,004 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,004 | 0,002 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,003 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,010 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».