Submitted: 20 Nov 2018
Revision: 14 Jul 2019
Accepted: 19 Jul 2019
ePublished: 28 Aug 2019
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J Cardiovasc Thorac Res. 2019;11(3): 224-229.
doi: 10.15171/jcvtr.2019.37
PMID: 31579463
PMCID: PMC6759610
  Abstract View: 231
  PDF Download: 156

Original Article

Better treatment option in chronic superficial femoral artery occlusive disease: comparison of methods (meta-analysis)

Vladimir Starodubtsev 1 * ORCID logo, Andrey Karpenko 1, Evgeniy Lenko 1, Pavel Ignatenko 1

1 Siberian Federal Biomedical Research Center, Ministry for Public Health Care of Russian Federation, Novosibirsk, Russian Federation


Introduction: The objective is to evaluate the frequency of primary obstruction events (PrO) during one-year follow-up after performing excisional atherectomy with the SilverHawk/TurboHawk atherectomy device (S/TH) or remote superficial femoral artery endarterectomy (RSFAE) in patients with the chronic superficial femoral artery occlusive disease (СSFAOD).
Methods: We included all randomized clinical trials (RCTs) and not-RCTs concerning the treatment of patients with СSFAOD after S/TH and RSFAE without duration.
Results: Twenty-nine items (1990-2017) were discovered; 27 articles on the levels of evidence were included in qualitative synthesis; 9 studies (meta-analysis) were included in quantitative synthesis. The results of 2762 patients’ treatment were summed up in our analysis (1422 patients S/TH; 1340 patients RSFAE). All included reports were at low risk of bias. According to the criterion “frequency of PrO” during one-year follow-up, the pooled Hazard Ratios indicate significant favours of S/TH if compared it with RSFAE (HR= 0.66 (0.57 to 0.76, P < 0.00001), I2 = 9%).
Conclusion: Our study showed that S/TH with the SpiderFX device (distal embolic protection) are safe and effective treatment option for short lesion (<15 cm) in patients with СSFAOD. The usage of S/TH methods significantly reduced number of PrO if compared it with RSFAE. In long-segment lesion (>15 cm) in patients with СSFAOD, RSFAE may be considered better than an endovascular procedure. But still it is necessary to conduct well-planned randomized studies to determine effectiveness and safety of the compared methods (S/TH and RSFAE) in patients with long-segment lesion (>15 cm).
Keywords: Excisional Atherectomy, Endovascular Procedure, Superficial Femoral Artery, Remote Endarterectomy, Chronic Occlusive Disease
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