title: Drug eluting stents versus bare metal stents for the treatment of extracranial vertebral artery disease: a meta-analysis.
abstract: BACKGROUND
  While a growing number of reports offer evidence for the potential of drug eluting stents (DES) in treating atherosclerotic stenosis of the extracranial vertebral artery, their efficacy when compared with bare metal stents (BMS) is uncertain due to the lack of a large prospective randomized trial.
  
  
  METHODS
  A search strategy using the terms 'stents', 'drug-eluting stents', 'atherosclerosis', 'vertebral artery', and 'vertebrobasilar insufficiency' was employed through Medline. Five studies met the criteria for a comparative meta-analysis. The technical/clinical success, periprocedural complications, target vessel revascularization (TVR), rates of restenosis, recurrent symptoms, and overall survival were compared.
  
  
  RESULTS
  There was no significant difference in the technical success (OR=1.528, p=0.622), clinical success (OR=1.917, p=0.274), and periprocedural complications (OR=0.741, p=0.614) between the two groups. An OR of 0.388 for no restenosis in the BMS to DES arms (p=0.001) indicated a significantly higher restenosis rate in the BMS group relative to the DES group (33.57% vs 15.49%). When compared with the DES group, the BMS group had a significantly higher rate of recurrent symptoms (2.76% vs 11.26%; OR=3.319, p=0.011) and TVR (4.83% vs 19.21%; OR=4.099, p=0.001).
  
  
  CONCLUSIONS
  A significantly lower rate of restenosis, recurrent symptoms, and TVR was noted in the DES group compared with the BMS group.
authors.affiliation: Texas Institute for Neurological Disorders (TIND), Sherman, Texas, USA.
authors.forename: Vivek H
authors.initials: VH
authors.lastname: Tank
authors.affiliation: Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
authors.forename: Ritam
authors.initials: R
authors.lastname: Ghosh
authors.affiliation: Department of Neurology, University of Missouri, Columbia, Missouri, USA.
authors.forename: Vikas
authors.initials: V
authors.lastname: Gupta
authors.affiliation: Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
authors.forename: Nakul
authors.initials: N
authors.lastname: Sheth
authors.affiliation: Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
authors.forename: Shariyah
authors.initials: S
authors.lastname: Gordon
authors.affiliation: Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
authors.forename: Wenzhuan
authors.initials: W
authors.lastname: He
authors.affiliation: Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
authors.forename: Steven F
authors.initials: SF
authors.lastname: Modica
authors.affiliation: Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Prestigiacomo
authors.affiliation: Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
authors.forename: Chirag D
authors.initials: CD
authors.lastname: Gandhi
mesh_terms: D054855:Drug-Eluting Stents; D006083:Graft Occlusion, Vascular; D006801:Humans; D008670:Metals; D015607:Stents; D014715:Vertebrobasilar Insufficiency / Q000601:surgery*
chemical_list: D008670:Metals
keywords: Atherosclerosis; Neck; Stenosis; Stent