Key result
Open-cell stents compared with closed-cell stents resulted in an odds ratio of 1.35 (95% CI 0.99-1.83; p=0.057) for 30-day transient ischemic attack, stroke, or death in symptomatic patients.
Why the study?
Does open-cell stent design compared to closed-cell stent design affect the 30-day risk of TIA, stroke, or death in symptomatic patients undergoing carotid artery stenting?
Systematic Review (n=4,352)
Does open-cell stent design compared to closed-cell stent design affect the 30-day risk of TIA, stroke, or death in symptomatic patients undergoing carotid artery stenting?
Odds Ratio: 1.35 (95% CI 0.99–1.83)
p-value: p=0.057
In symptomatic patients undergoing carotid artery stenting, closed-cell stents may be associated with a reduced 30-day risk of TIA, stroke, or death compared to open-cell stents, though the difference was of borderline statistical significance.
May favor closed-cell stents to lower 30-day events in symptomatic carotid stenting; leaves open confirmation in randomized trials.
Carotid artery stenting is an alternative to carotid endarterectomy in select patients. The stroke and death rate following carotid artery stenting must be reduced to allow more general use of this technology. Online databases were utilized to review the impact of stent design. Results specifically for symptomatic patients were reported by four investigators and these data were pooled. A total of 4352 symptomatic patients were pooled (1892 closed cell and 2460 open cell). The odds ratio when comparing open-cell stents with closed-cell stents was 1.35 (95% CI: 0.99–1.83; p = 0.057) for the end point of a 30-day transient ischemic attack, stroke or death. Symptomatic patients with favorable anatomy may have a reduced 30-day risk of transient ischemic attack, stroke or death when closed-cell stents are utilized.
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Tadros et al. (2013) conducted a systematic review in Symptomatic patients undergoing carotid artery stenting (n=4,352). Open-cell stents vs. Closed-cell stents was evaluated on 30-day transient ischemic attack, stroke or death (OR 1.35, 95% CI 0.99-1.83, p=0.057). Open-cell stents compared with closed-cell stents resulted in an odds ratio of 1.35 (95% CI 0.99-1.83; p=0.057) for 30-day transient ischemic attack, stroke, or death in symptomatic patients.
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