Biomaterial Database

Center volume and the outcomes of percutaneous transluminal angioplasty and stenting in patients with symptomatic intracranial vertebrobasilar stenoses: A meta-analysis. 2018

Ying Mao, and Guangxian Nan

Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, China.

Evidence for the preventative effects of percutaneous transluminal angioplasty and stenting (PTAS) on the recurrence of stroke in patients with severe intracranial vertebrobasilar stenoses (IVBS) varies, and the influence of study characteristics on the study outcomes have not been determined. A study level based meta-analysis was performed to investigate the influence of baseline characteristics on the 30-day and follow-up stroke recurrence or death in symptomatic IVBS patients receiving PTAS. Relevant single center studies were retrieved by searching PubMed and Embase. A random effect model was applied to synthesize the outcomes. Meta-regression and subgroup analyses were performed to evaluate the potential influence of study characteristics on outcomes. Fifteen cohort studies comprising 554 symptomatic IVBS patients were included. PTAS was associated with an 8% incidence of stroke recurrence or death (95% CI: 5% to 12%) in IVBS patients within 30 days, and 8 per 100 person-years (95% CI: 5 to 11 per 100 person-years) of cumulative stroke recurrence or death during follow-up. Meta-regression indicated that the center volume, as defined by the numbers of cases per year, was negatively correlated with 30-day (regression coefficient = -0.09, p = 0.02) and follow-up (regression coefficient = -0.60, p = 0.01) stroke recurrence or death. Age, gender, or comorbidities have no significant effect on the outcomes. Centers of higher procedural volume may be associated with better clinical outcomes for symptomatic IVBS patients receiving PTAS.

UI	MeSH Term	Description	Entries
D012008	Recurrence	The return of a sign, symptom, or disease after a remission.	Recrudescence,Relapse,Recrudescences,Recurrences,Relapses
D006268	Health Facilities	Institutions which provide medical or health-related services.	Facilities, Health,Facility, Health,Health Facility
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014715	Vertebrobasilar Insufficiency	Localized or diffuse reduction in blood flow through the vertebrobasilar arterial system, which supplies the BRAIN STEM; CEREBELLUM; OCCIPITAL LOBE; medial TEMPORAL LOBE; and THALAMUS. Characteristic clinical features include SYNCOPE; lightheadedness; visual disturbances; and VERTIGO. BRAIN STEM INFARCTIONS or other BRAIN INFARCTION may be associated.	Basilar Artery Insufficiency,Basilar Artery Stenosis,Vertebral Artery Insufficiency,Vertebral Artery Stenosis,Basilar Artery Ischemia,Basilar Insufficiency,Vertebral Artery Ischemia,Vertebro-Basilar Insufficiency,Vertebro-Basilar Ischemia,Vertebrobasilar Dolichoectasia,Vertebrobasilar Ischemia,Artery Insufficiencies, Basilar,Artery Insufficiencies, Vertebral,Artery Insufficiency, Basilar,Artery Insufficiency, Vertebral,Artery Ischemia, Basilar,Artery Ischemia, Vertebral,Artery Ischemias, Basilar,Artery Ischemias, Vertebral,Artery Stenoses, Basilar,Artery Stenoses, Vertebral,Artery Stenosis, Basilar,Artery Stenosis, Vertebral,Basilar Artery Insufficiencies,Basilar Artery Ischemias,Basilar Artery Stenoses,Basilar Insufficiencies,Dolichoectasia, Vertebrobasilar,Dolichoectasias, Vertebrobasilar,Insufficiencies, Basilar,Insufficiencies, Basilar Artery,Insufficiencies, Vertebral Artery,Insufficiencies, Vertebro-Basilar,Insufficiencies, Vertebrobasilar,Insufficiency, Basilar,Insufficiency, Basilar Artery,Insufficiency, Vertebral Artery,Insufficiency, Vertebro-Basilar,Insufficiency, Vertebrobasilar,Ischemia, Basilar Artery,Ischemia, Vertebral Artery,Ischemia, Vertebro-Basilar,Ischemia, Vertebrobasilar,Ischemias, Basilar Artery,Ischemias, Vertebral Artery,Ischemias, Vertebro-Basilar,Ischemias, Vertebrobasilar,Stenoses, Basilar Artery,Stenoses, Vertebral Artery,Stenosis, Basilar Artery,Stenosis, Vertebral Artery,Vertebral Artery Insufficiencies,Vertebral Artery Ischemias,Vertebral Artery Stenoses,Vertebro Basilar Insufficiency,Vertebro Basilar Ischemia,Vertebro-Basilar Insufficiencies,Vertebro-Basilar Ischemias,Vertebrobasilar Dolichoectasias,Vertebrobasilar Insufficiencies,Vertebrobasilar Ischemias
D015607	Stents	Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting.	Stent
D017130	Angioplasty	Reconstruction or repair of a blood vessel, which includes the widening of a pathological narrowing of an artery or vein by the removal of atheromatous plaque material and/or the endothelial lining as well, or by dilatation (BALLOON ANGIOPLASTY) to compress an ATHEROMA. Except for ENDARTERECTOMY, usually these procedures are performed via catheterization as minimally invasive ENDOVASCULAR PROCEDURES.	Angioplasty, Transluminal,Endoluminal Repair,Percutaneous Transluminal Angioplasty,Angioplasties,Angioplasty, Percutaneous Transluminal,Endoluminal Repairs,Repair, Endoluminal,Repairs, Endoluminal,Transluminal Angioplasty,Transluminal Angioplasty, Percutaneous
D055502	Secondary Prevention	The prevention of recurrences or exacerbations of a disease or complications of its therapy.	Disease Prevention, Secondary,Early Therapy,Relapse Prevention,Secondary Disease Prevention,Disease Preventions, Secondary,Early Therapies,Prevention, Relapse,Prevention, Secondary,Prevention, Secondary Disease,Preventions, Relapse,Preventions, Secondary,Preventions, Secondary Disease,Relapse Preventions,Secondary Disease Preventions,Secondary Preventions,Therapies, Early,Therapy, Early
D020521	Stroke	A group of pathological conditions characterized by sudden, non-convulsive loss of neurological function due to BRAIN ISCHEMIA or INTRACRANIAL HEMORRHAGES. Stroke is classified by the type of tissue NECROSIS, such as the anatomic location, vasculature involved, etiology, age of the affected individual, and hemorrhagic vs. non-hemorrhagic nature. (From Adams et al., Principles of Neurology, 6th ed, pp777-810)	Apoplexy,Cerebral Stroke,Cerebrovascular Accident,Cerebrovascular Apoplexy,Vascular Accident, Brain,CVA (Cerebrovascular Accident),Cerebrovascular Accident, Acute,Cerebrovascular Stroke,Stroke, Acute,Acute Cerebrovascular Accident,Acute Cerebrovascular Accidents,Acute Stroke,Acute Strokes,Apoplexy, Cerebrovascular,Brain Vascular Accident,Brain Vascular Accidents,CVAs (Cerebrovascular Accident),Cerebral Strokes,Cerebrovascular Accidents,Cerebrovascular Accidents, Acute,Cerebrovascular Strokes,Stroke, Cerebral,Stroke, Cerebrovascular,Strokes,Strokes, Acute,Strokes, Cerebral,Strokes, Cerebrovascular,Vascular Accidents, Brain