Evidence mapPaperPMID 36721954Full record

SynthesisEuropean heart journal2023

Endovascular revascularization strategies for aortoiliac and femoropopliteal artery disease: a meta-analysis.

David Koeckerling, Peter Francis Raguindin, Lum Kastrati, Sarah Bernhard, Joseph Barker, Andrea Carolina Quiroga Centeno, Hamidreza Raeisi-Dehkordi, Farnaz Khatami, Christa Niehot, Anne Lejay and 5 more

Open access · hybridAbstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in European heart journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 1 pooled it
19.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 1 synthesis or guideline pooled it, 61 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Major Adverse Limb Events and Death After Successful Endovascular Revascularization: BEST-CLI Trial.Journal of the Society for Cardiovascular Angiography & Interventions · 2026
    Article
  5. Article
  6. Article
  7. Review
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Review
  14. Review
  15. Article
  16. Article
  17. Article
  18. Article
  19. Drug-eluting devices for lower limb peripheral arterial disease.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2024
    Review
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors at 7 institutions in 8 countries.

David KoeckerlingDivision of Angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010 Bern, Switzerland.ORCID 0000-0002-8475-2861
Peter Francis RaguindinInstitute of Social and Preventive Medicine (ISPM), University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland.
Lum KastratiInstitute of Social and Preventive Medicine (ISPM), University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland.
Sarah BernhardDivision of Angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010 Bern, Switzerland.
Joseph BarkerDepartment of Cardiovascular Sciences, University of Leicester, University Rd, Leicestershire LE1 7RH, UK.ORCID 0000-0002-5483-9608
Andrea Carolina Quiroga CentenoDepartment of Surgery, Universidad Industrial de Santander, Cl. 9 Cra 27, Bucaramanga, Santander, Colombia.
Hamidreza Raeisi-DehkordiInstitute of Social and Preventive Medicine (ISPM), University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland.ORCID 0000-0002-5538-6073
Farnaz KhatamiInstitute of Social and Preventive Medicine (ISPM), University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland.
Christa NiehotLiterature Searches Support, 3314SC Dordrecht, the Netherlands.
Anne LejayDepartment of Vascular Surgery and Kidney Transplantation, University of Strasbourg, 4 rue Kirschleger, 67085 Strasbourg, France.
Zoltan SzeberinDepartment of Vascular Surgery, Semmelweis University, XII. Városmajor u. 68., 1122 Budapest, Hungary.
Christian-Alexander BehrendtDepartment of Vascular and Endovascular Surgery, Asklepios Clinic Wandsbek, Asklepios Medical School, Alphonsstraße 14, 22043 Hamburg, Germany.
Joakim NordanstigDepartment of Vascular Surgery and Institute of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska University Hospital and Academy, Gothenburg University, Blå stråket 5, 413 45 Gothenburg, Sweden.ORCID 0000-0002-2670-2268
Taulant MukaInstitute of Social and Preventive Medicine (ISPM), University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland.ORCID 0000-0003-3235-3073
Iris BaumgartnerDivision of Angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010 Bern, Switzerland.
University of Bern · CHAsklepios · DEIndustrial University of Santander · COSahlgrenska University Hospital · SESemmelweis University · HUUniversité de Strasbourg · FRUniversity of Leicester · GB

Funding

European Union's Horizon 2020GlobalP3HSMarie Skłodowska-Curie 801076NIHRSwiss National Science Foundation SNSF IZSTZ0_190277
6 · The paper itself

Abstract

aimsOptimal endovascular management of intermittent claudication (IC) remains disputed. This systematic review and meta-analysis compares efficacy and safety outcomes for balloon angioplasty (BA), bare-metal stents (BMS), drug-coated balloons (DCB), drug-eluting stents (DES), covered stents, and atherectomy. METHODS AND

resultsElectronic databases were searched for randomized, controlled trials (RCT) from inception through November 2021. Efficacy outcomes were primary patency, target-lesion revascularization (TLR), and quality-of-life (QoL). Safety endpoints were all-cause mortality and major amputation. Outcomes were evaluated at short-term (<1 year), mid-term (1-2 years), and long-term (≥2 years) follow-up. The study was registered on PROSPERO (CRD42021292639). Fifty-one RCTs enrolling 8430 patients/lesions were included. In femoropopliteal disease of low-to-intermediate complexity, DCBs were associated with higher likelihood of primary patency [short-term: odds ratio (OR) 3.21, 95% confidence interval (CI) 2.44-4.24; long-term: OR 2.47, 95% CI 1.93-3.16], lower TLR (short-term: OR 0.33, 95% CI 0.22-0.49; long-term: OR 0.42, 95% CI 0.29-0.60) and similar all-cause mortality risk, compared with BA. Primary stenting using BMS was associated with improved short-to-mid-term patency and TLR, but similar long-term efficacy compared with provisional stenting. Mid-term patency (OR 1.64, 95% CI 0.89-3.03) and TLR (OR 0.50, 95% CI 0.22-1.11) estimates were comparable for DES vs. BMS. Atherectomy, used independently or adjunctively, was not associated with efficacy benefits compared with drug-coated and uncoated angioplasty, or stenting approaches. Paucity and heterogeneity of data precluded pooled analysis for aortoiliac disease and QoL endpoints.

conclusionCertain devices may provide benefits in femoropopliteal disease, but comparative data in aortoiliac arteries is lacking. Gaps in evidence quantity and quality impede identification of the optimal endovascular approach to IC.

Indexed as

Angioplasty, BalloonPeripheral Arterial DiseaseFemoral ArteryHumansPopliteal ArteryRisk FactorsTreatment OutcomeVascular PatencyangioplastyAtherectomyDrug-coated balloonDrug-eluting stentEndovascular revascularizationIntermittent claudication

Identifiers

PMID36721954
PMCPMC10011342
OpenAlexW4318755128

What Socratic holds

Textmetadata
LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.