title: Comparing Percutaneous Transluminal Angioplasty and Stent Placement for Treatment of Subclavian Arterial Occlusive Disease: A Systematic Review and Meta-Analysis.
abstract: Subclavian artery occlusive disease (SAOD) is often associated with cerebrovascular symptoms such as subclavian steal syndrome and stroke. We conducted a systematic review and meta-analysis to compare percutaneous transluminal angioplasty (PTA) and stent placement for the treatment of SAOD.
  
  
  
  We searched Medline, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus through October 16, 2014. From each study, we abstracted baseline patient characteristics, study design variables, and outcome data including rates of technical success, primary patency (≤2 and >2 years follow-up), symptom resolution, and complications. Meta-analysis was performed using a random-effects model.
  
  
  
  A total of 35 non-comparative studies with 1726 patients were included. Technical success rate was significantly higher in the stent group than the PTA group (92.8 vs 86.8%, p = 0.007). Long-term primary patency rates (76.9 vs 79.6%, p = 0.729) and symptom resolution rates (82.2 vs 73.0%, p = 0.327) were not statistically different. There was no statistically significant difference in the rates of stroke or death.
  
  
  
  Stent placement for treatment of SAOD may be associated with higher rates of technical success but similar rates of symptom resolution and long-term outcomes. The confidence in the available estimates is low. Further comparative studies are needed to guide patients and clinicians in shared decision making.
authors.affiliation: Evidence-Based Practice Research Program, Mayo Clinic, 200 1st Street Southwest, Harwick Building 2-50, Rochester, MN, 55905, USA. Ahmed.Ahmed1@mayo.edu.|Division of Preventive, Occupational and Aerospace Medicine, Mayo Clinic, 200 1st Street Southwest, Rochester, MN, 55905, USA. Ahmed.Ahmed1@mayo.edu.
authors.forename: Ahmed T
authors.initials: AT
authors.lastname: Ahmed
authors.affiliation: Evidence-Based Practice Research Program, Mayo Clinic, 200 1st Street Southwest, Harwick Building 2-50, Rochester, MN, 55905, USA.|Division of Preventive, Occupational and Aerospace Medicine, Mayo Clinic, 200 1st Street Southwest, Rochester, MN, 55905, USA.
authors.forename: Khaled
authors.initials: K
authors.lastname: Mohammed
authors.affiliation: Department of Diagnostic Radiology and Molecular Imaging, Oakland University William Beaumont School of Medicine, 3601 W 13 Mile Road, Royal Oak, MI, 48073, USA.
authors.forename: Monzer
authors.initials: M
authors.lastname: Chehab
authors.affiliation: Department of Radiology, Mayo Clinic, 200 1st Street Southwest, Rochester, MN, 55905, USA.
authors.forename: Waleed
authors.initials: W
authors.lastname: Brinjikji
authors.affiliation: Evidence-Based Practice Research Program, Mayo Clinic, 200 1st Street Southwest, Harwick Building 2-50, Rochester, MN, 55905, USA.|Division of Preventive, Occupational and Aerospace Medicine, Mayo Clinic, 200 1st Street Southwest, Rochester, MN, 55905, USA.
authors.forename: M Hassan
authors.initials: MH
authors.lastname: Murad
authors.affiliation: Department of Radiology, Mayo Clinic, 200 1st Street Southwest, Rochester, MN, 55905, USA.
authors.forename: Harry
authors.initials: H
authors.lastname: Cloft
authors.affiliation: Department of Radiology, Mayo Clinic, 200 1st Street Southwest, Rochester, MN, 55905, USA.
authors.forename: Haraldur
authors.initials: H
authors.lastname: Bjarnason
mesh_terms: D017130:Angioplasty; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D006801:Humans; D015607:Stents; D020521:Stroke / Q000209:etiology; D013348:Subclavian Artery / Q000601:surgery*; D013349:Subclavian Steal Syndrome / Q000209:etiology
keywords: Arterial intervention; Diagnostic; Endovascular Aneurysm Repair/Endovascular Aortic Repair (EVAR); Endovascular treatment; Inferior Vena Cava Filter (IVC) placement; Neurointerventions; Venous intervention