title: Meta-analysis of the Effect of Stent Design on 30-Day Outcome After Carotid Artery Stenting.
abstract: OBJECTIVE
  To review the contemporary literature and analyze whether stent cell design plays a role in 30-day outcomes after carotid artery stenting (CAS).
  
  
  METHODS
  A systematic review of the literature was undertaken that identified 9 studies comparing the effect of different cell design on 30-day outcome in patients undergoing CAS. Random-effects models were applied to calculate pooled outcome data for mortality and cerebrovascular morbidity. Results are reported as the odds ratio (OR) and 95% confidence interval (CI).
  
  
  RESULTS
  The 9 studies included 8018 patients who underwent 8028 CAS procedures (4018 open-cell stents, 4010 closed-cell stents). Six studies were retrospective in design, one was a registry, and only two studies prospectively compared the effect of different cell designs. Nearly half of the patients (3452, 43.1%) were symptomatic, with no significant difference between the closed- and open-cell stent groups (p=0.93). During the first month after the procedure, there were no significant differences in mortality (OR 0.69, 95% CI 0.39 to 1.24, p=0.21), transient ischemic attacks (OR 0.95, 95% CI 0.69 to 1.30, p=0.74), or strokes (OR 1.17, 95% CI 0.83 to 1.66, p=0.37).
  
  
  CONCLUSIONS
  This meta-analysis showed that 30-day cerebrovascular complications after CAS were not significantly different for the open-cell group in comparison to the closed-cell group. Future prospective clinical trials comparing different free cell areas and other stent design properties are still needed to further investigate whether stent design plays a significant role in the results of carotid stenting.
authors.affiliation: Department of Surgery, Vascular Surgery Unit, Medical School, University of Ioannina, Greece.
authors.forename: George N
authors.initials: GN
authors.lastname: Kouvelos
authors.affiliation: First Department of Surgery, Vascular Surgery Unit, Medical School, University of Athens, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Patelis
authors.affiliation: Liverpool Vascular and Endovascular Service, Royal Liverpool University Hospital, Liverpool, UK.
authors.forename: George A
authors.initials: GA
authors.lastname: Antoniou
authors.affiliation: Third Department of Surgery, Vascular Surgery Unit, University of Athens, Greece.
authors.forename: Andreas
authors.initials: A
authors.lastname: Lazaris
authors.affiliation: Department of Surgery, Vascular Surgery Unit, Medical School, University of Ioannina, Greece mimats@cc.uoi.gr.
authors.forename: Miltiadis I
authors.initials: MI
authors.lastname: Matsagkas
mesh_terms: D000368:Aged; D017130:Angioplasty / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D002340:Carotid Artery Diseases / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000209:etiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011474:Prosthesis Design; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D020521:Stroke / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome
keywords: carotid artery stenting; closed cell; complications; mortality; open cell; stent design; stroke; transient ischemic attack