title: Network meta-analysis of balloon angioplasty, nondrug metal stent, drug-eluting balloon, and drug-eluting stent for treatment of infrapopliteal artery occlusive disease.
abstract: OBJECTIVE
  We aimed to conduct a network meta-analysis of mixed treatments for the infrapopliteal artery occlusive disease.
  
  
  METHODS
  We searched randomized controlled trials (RCTs) regarding balloon angioplasty (BA), nondrug metal stent (NDMS), drug-eluting balloon (DEB), or drug-eluting stent (DES) in PubMed, Embase, CENTRAL, Ovid, Sinomed, and other relevant websites. We selected and assessed the trials that met the inclusion criteria and conducted a network meta-analysis using the ADDIS software.
  
  
  RESULTS
  We included 11 relevant trials. We analyzed data of 1322 patients with infrapopliteal artery occlusive disease, of which 351 were in the NDMS vs. DES trials, 231 in the NDMS vs. BA trials, 490 in the BA vs. DEB trials, 50 in the DEB vs. DES trials, and 200 in the BA vs. DES trials. The network meta-analysis indicated that with NDMS as the reference, DES had a better result with respect to restenosis (odds ratio [OR], 5.16; 95% credible interval [CI], 1.58-18.41; probability of the best treatment, 84%) and amputation (OR, 2.50; 95% CI, 0.81-7.11; probability of the best treatment, 61%) and DEB had a better result with respect to target lesion revascularization (TLR; OR, 3.74; 95% CI, 0.78-17.05; probability of the best treatment, 57%). Moreover, with BA as the reference, NDMS had a better result with respect to technical success (OR, 0.10; 95% CI, 0.00-1.15; probability of the best treatment, 86%).
  
  
  CONCLUSIONS
  Our meta-analysis revealed that DES is a better treatment with respect to short-term patency and limb salvage rate, NMDS may provide a better technical success, and DEB and DES are good choices for reducing revascularization.
authors: Department of Vascular Surgery, Beijing Anzhen Hospital Affiliated to Capital Medical University and Beijing Institution of Heart Lung and Vessel Disease, Beijing, China. chenzhongxgk@163.com.
authors: Yaowen
authors: Y
authors: Xiao
authors: Zhong
authors: Z
authors: Chen
authors: Yaoguo
authors: Y
authors: Yang
authors: Lei
authors: L
authors: Kou
mesh_terms: D000800:Angioplasty, Balloon / Q000295:instrumentation*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D058729:Peripheral Arterial Disease / Q000628:therapy*; D011150:Popliteal Artery / Q000473:pathology*; D011474:Prosthesis Design; D015607:Stents; D016896:Treatment Outcome; D062666:Vascular Access Devices