Network Meta-Analysis Evaluates Endovascular Interventions for Femoropopliteal Disease
November 8, 2017—Findings from a study using network meta-analysis (NMA) to determine the optimal endovascular strategy for managing femoropopliteal peripheral artery disease was published online ahead of print by Michael R. Jaff, DO, et al in Journal of Vascular and Interventional Radiology (JVIR).
According to the investigators, NMA permits comparisons among any two therapies by combining results of a collection of clinical trials conducted in the same or similar patient population. NMA was used to analyze data from 15 randomized controlled trials (RCTs) and 10 prospective, multicenter, single-arm trials (combined evidence [CE] NMA) that evaluated target lesion revascularization (TLR) for five endovascular strategies using a bare-metal stent (BMS), polymer-covered metal stent (CMS), drug-eluting stent (DES), drug-coated balloon (DCB), or percutaneous transluminal angioplasty (PTA).
As summarized in JVIR, the RCT and CE NMAs included 2,912 and 6,091 patients with 3,151 and 6,786 person-years of follow-up, respectively. In the CE NMA, DCBs provided a statistically significant 68% reduction in TLR compared with PTA and a statistically significant 53% reduction in TLR compared with BMSs. Use of a BMS, CMS, or DES provided TLR reductions of 33%, 48%, and 58%, respectively, compared with PTA, with statistical significance achieved for CMSs and DESs. The significant reductions in TLR with DCBs compared with PTA and BMSs were replicated in the RCT NMA.
This NMA demonstrated that DCBs provided greater reduction in TLR rates compared with PTA and BMSs, concluded the investigators in JVIR.