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SYSTEMATIC REVIEW article

Front. Neurol.
Sec. Endovascular and Interventional Neurology
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1389254

Efficacy and Safety of Drug-Eluting Stents versus Bare-Metal Stents in Symptomatic Intracranial and Vertebral Artery Stenosis: A Meta-Analysis

Provisionally accepted
Yidan Zhang Yidan Zhang 1*Wenbin Li Wenbin Li 2Lei Zhang Lei Zhang 2*
  • 1 Department of Emergency Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
  • 2 Department of neurovascular disease, the Fifth affiliated hospital of Sun Yat-Sen university, Zhuhai Guangdong 519000, China, Zhuhai, China

The final, formatted version of the article will be published soon.

    Objectives: This study aims to present the first comprehensive meta-analysis assessing the effectiveness and safety of drug-eluting stents (DES) versus bare-metal stents (BMS) in treating intracranial and vertebral artery stenosis.A comprehensive examination was undertaken to compare the effectiveness and safety of DES and BMS in individuals experiencing symptomatic stenosis in the intracranial and vertebral arteries through an in-depth analysis of clinical research. We conducted an extensive search across multiple databases including PubMed, Embase, Web of Science, and the Cochrane Library up to September 2024. The emphasis of our investigation was on various outcomes including rates of in-stent restenosis, symptomatic occurrences of in-stent restenosis, incidence of stroke, procedural success, mortality rates, complications associated with the procedure, and any adverse events.Results: Our analysis included 12 studies with a total of 1,243 patients (562 in the DES group and 681 in the BMS group). The findings demonstrated a significantly lower rate of in-stent restenosis in the DES group for both intracranial (Odds Ratio[OR]: 0.23; 95% Confidence Interval [CI]: 0.13 to 0.41; P < 0.00001) and vertebral artery stenosis (OR: 0.38; 95% CI: 0.20 to 0.72; P = 0.003) compared to the BMS group. Additionally, the DES group showed a significantly reduced rate of postoperative strokes in vertebral artery stenosis cases (OR: 0.38; 95% CI: 0.16 to 0.90; P = 0.03), with no significant differences noted in the intracranial artery stenosis comparison (OR: 0.63; 95% CI: 0.20 to 1.95; P = 0.42). The study also revealed no significant disparities in symptomatic in-stent restenosis, procedural success, mortality, adverse effects, and perioperative complications between the two groups across the conditions studied.The comparison indicates that DES significantly reduces the risk of instent restenosis and postoperative strokes in patients with vertebral artery stenosis, compared to BMS. For both intracranial and vertebral artery stenosis, DES and BMS exhibit comparable safety profiles.

    Keywords: Drug-eluting stent, bare-metal stent, Intracranial artery stenosis, Vertebral artery stenosis, Meta-analysis

    Received: 28 Apr 2024; Accepted: 14 Oct 2024.

    Copyright: © 2024 Zhang, Li and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Yidan Zhang, Department of Emergency Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
    Lei Zhang, Department of neurovascular disease, the Fifth affiliated hospital of Sun Yat-Sen university, Zhuhai Guangdong 519000, China, Zhuhai, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.