Peripheral Arterial DiseaseMeta-Analysis of Revascularization Versus Medical Therapy for Atherosclerotic Renal Artery Stenosis
Section snippets
Methods
Literature search was conducted using methods described in the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement.14 Medline (PubMed and Ovid SP), Embase, Cochrane Central Register of Controlled Clinical Trials (CENTRAL), and Cochrane Database of Systematic Review (CDSR) were searched from the inception of these databases till present (November 2013). We used “renal artery stenosis,” “randomized controlled trials,” “angioplasty,” “surgical intervention,” and
Results
We found 540 titles during the initial database search. After screening the titles, 95 studies were eligible for further review, and 7 randomized controlled trials1, 16, 17, 18, 19, 20, 21 were included in the meta-analysis. The search strategy is shown in the PRISMA sheet (Figure 1).
In the included trials, intensive medical therapy was compared against angioplasty with1, 16, 21 or without stenting19, 20 in the patients with ARAS. The primary outcome measure was systolic blood pressure
Discussion
In the present meta-analysis, we report aggregate data from 7 randomized controlled trials on the efficacy of renal vascular interventions (angioplasty or stenting) compared with medical therapy in ARAS. Our results failed to demonstrate superiority of angioplasty or stenting versus medical therapy across a wide range of clinical end points including systolic blood pressure, death, nonfatal MI, hospitalization because of CHF, stroke, and worsening of renal function with the resultant need for
Disclosures
The authors have no conflicts of interest to disclose.
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