Key result
Pulmonary vein stenting is associated with lower re-intervention risk and similar safety versus balloon angioplasty.
Why the study?
Pulmonary vein stenosis causes morbidity and mortality across adults and children and can be managed percutaneously with balloon angioplasty or stent implantation.
Does pulmonary vein stent implantation reduce the risk of restenosis requiring re-intervention and procedural complications compared to balloon angioplasty in patients with pulmonary vein stenosis?
Meta-Analysis
Does pulmonary vein stent implantation reduce the risk of restenosis requiring re-intervention and procedural complications compared to balloon angioplasty in patients with pulmonary vein stenosis?
Pulmonary vein stent implantation should be considered first-line therapy for pulmonary vein stenosis as it reduces the risk of re-intervention and is as safe as balloon angioplasty.
Supports first-line pulmonary vein stenting; extends Level 1 evidence confirming lower re-intervention rates with equivalent safety.
BACKGROUND: Pulmonary vein stenosis (PVS) is an uncommon but known cause of morbidity and mortality in adults and children and can be managed with percutaneous re-vascularization strategies of pulmonary vein balloon angioplasty (PBA) or pulmonary vein stent implantation (PSI). AIM: PSI in all patient categories with PVS. METHODS: PSI for PVS with reported outcomes of restenosis and procedure-related complications in all patient categories. In adults, PVS following atrial fibrillation ablation and in children PVS related to congenital etiology or post-procedural PVS following total or partial anomalous pulmonary venous return repair were included. The patient-centered outcomes were risk of restenosis requiring re-intervention and procedural-related complications. The meta-analysis was performed by computing odds ratios (ORs) using the random effects model based on underlying statistical heterogeneity. CONCLUSION: Across all patient categories with PVS, PSI is associated with reduced risk of re-intervention and is as safe as PBA and should be considered first-line therapy for PVS.
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Agasthi et al. (2023) conducted a meta-analysis in Pulmonary vein stenosis. Pulmonary vein stent implantation (PSI) vs. Pulmonary vein balloon angioplasty (PBA) was evaluated on Risk of restenosis requiring re-intervention and procedural-related complications. Pulmonary vein stent implantation is associated with reduced risk of re-intervention and is as safe as balloon angioplasty across all patient categories with pulmonary vein stenosis.
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