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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Safety and efficacy of balloon angioplasty compared to stent-based-strategies with pulmonary vein stenosis: A systematic review and meta-analysis
Pradyumna Agasthi, Srilekha Sridhara, Pattara Rattanawong, Nithin Venepally, Chieh-Ju Chao, Hasan Ashraf, Sai Harika Pujari, Mohamed Allam, Diana Almader-Douglas, Yamini Alla, Amit Kumar, Farouk Mookadam, Douglas L Packer, David R Holmes Jr, Donald J Hagler, Floyd David Fortuin, Reza Arsanjani
Pradyumna Agasthi, Pattara Rattanawong, Nithin Venepally, Chieh-Ju Chao, Hasan Ashraf, Sai Harika Pujari, Mohamed Allam, Amit Kumar, Farouk Mookadam, Floyd David Fortuin, Reza Arsanjani, Department of Cardiovascular Diseases, Mayo Clinic, Scottsdale, AZ 85259, United States
Srilekha Sridhara, Department of Internal Medicine, Banner Heart Hospital, Mesa, AZ 85054, United States
Diana Almader-Douglas, Library Services, Mayo Clinic, Phoenix, AZ 85054, United States
Yamini Alla, Department of Medicine, Bronx Lebanon Hospital, Bronx, NY 10457, United States
Douglas L Packer, David R Holmes Jr, Donald J Hagler, Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, United States
Author contributions: Agasthi P and Sridhara S contributed equally to this work; Agasthi P, Sridhara S, Mookadam F, Fortuin FD and Arsanjani R, designed the research study; Agasthi P, Sridhara S, Rattanawong P, Venepally NR, Chao C, Ashraf H and Pujari S performed the research; Douglas DA, Allam Mohamed, Alla Y, Kumar A contributed new reagents and analytic tools; Agasthi P, Sridhara S, Rattanawong P, Venepally NR, Chao C, Ashraf H, Pujari S and Allam M analyzed the data and wrote the manuscript; Mookadam F, Packer DL, Holmes DR Jr, Hagler DJ, Fortuin FD and Arsanjani R reviewed the manuscript before submission; All authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors received no financial support for the research, authorship, and/or publication of this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Nithin Venepally, MD, Academic Research, Department of Cardiovascular Diseases, Mayo Clinic, 5777 E Mayo Blvd, Scottsdale, AZ 85259, United States. nrvenepally@gmail.com
Received: September 19, 2022
Peer-review started: September 19, 2022
First decision: November 2, 2022
Revised: November 17, 2022
Accepted: February 8, 2023
Article in press: Feburary 8, 2023
Published online: February 26, 2023
Processing time: 155 Days and 3.5 Hours
ARTICLE HIGHLIGHTS
Research background
Pulmonary vein balloon angioplasty (PBA) and pulmonary vein stent implantation (PSI) are the two re-vascularization strategies used to manage pulmonary vein stenosis.
Research motivation
Both these strategies are widely used to treat pulmonary vein stenosis. Our study tends to explore outcomes and complications with each of these strategies
Research objectives
Our study tried to explore the safety and efficacy outcomes of two re-vascularization strategies Pulmonary vein balloon angioplasty vs pulmonary vein stent implantation in the management of pulmonary vein stenosis.
Research methods
The meta-analysis was performed by computing odds ratios using the random effects model based on underlying statistical heterogeneity.
Research results
The primary outcome of the re-stenosis requiring re-intervention occurred in 196 of 325 veins in the PBA group and 111 of 443 veins in the PSI group. Compared to PSI, PBA was associated with a significantly increased risk of restenosis (OR 2.91, 95%CI: 1.15-7.37, P = 0.025, I2 = 79.2%).
Research conclusions
Percutaneous re-vascularization with stents appears to be superior to PBA, in regard to re-stenosis and the need for re-intervention. Hence, stenting should be considered as the first line of choice over balloon angioplasty.
Research perspectives
A further follow-up to ascertain the real success of the intervention and the re-stenosis patterns is crucial.
