title: Selective-versus-Standard Poststent Dilation for Carotid Artery Disease: A Systematic Review and Meta-Analysis.
abstract: BACKGROUND
  The safety and efficacy of standard poststent angioplasty in patients undergoing carotid artery stent placement have not been well-established.
  
  
  OBJECTIVE
  We conducted a systematic review of the literature to evaluate the safety and efficacy of carotid artery stent placement and analyzed outcomes of standard-versus-selective poststent angioplasty.
  
  
  METHODS
  A systematic search of MEDLINE, EMBASE, Scopus, and the Web of Science was performed for studies published between January 2000 and January 2015.
  
  
  METHODS
  We included studies with >30 patients describing standard or selective poststent angioplasty during carotid artery stent placement.
  
  
  METHODS
  A random-effects meta-analysis was used to pool the following outcomes: periprocedural stroke/TIA, procedure-related neurologic/cardiovascular morbidity/mortality, bradycardia/hypotension, long-term stroke at last follow-up, long-term primary patency, and technical success.
  
  
  RESULTS
  We included 87 studies with 19,684 patients with 20,378 carotid artery stenoses. There was no difference in clinical (P= .49) or angiographic outcomes (P= .93) in carotid artery stent placement treatment with selective or standard poststent balloon angioplasty. Both selective and standard poststent angioplasty groups had a very high technical success of >98% and a low procedure-related mortality of 0.9%. There were no significant differences between both groups in the incidence of restenosis (P= .93) or procedure-related complications (P= .37).
  
  
  CONCLUSIONS
  No comparison to a patient group without poststent dilation could be performed.
  
  
  CONCLUSIONS
  Our meta-analysis demonstrated no significant difference in angiographic and clinical outcomes among series that performed standard poststent angioplasty and those that performed poststent angioplasty in only select patients.
authors.affiliation: From the Departments of Neurologic Surgery (O.P., G.L.) petr.ondra@mayo.edu ondra.petr@yahoo.com.|Neurosurgery (O.P.), Medical University Innsbruck, Innsbruck, Austria.
authors.forename: O
authors.identifier: http://orcid.org/0000-0002-2258-1032
authors.initials: O
authors.lastname: Petr
authors.affiliation: Radiology (W.B., G.L.).
authors.forename: W
authors.identifier: http://orcid.org/0000-0001-5271-5524
authors.initials: W
authors.lastname: Brinjikji
authors.affiliation: Division of Preventive Medicine (M.H.M.), Mayo Clinic, Rochester, Minnesota.
authors.forename: M H
authors.identifier: http://orcid.org/0000-0001-5502-5975
authors.initials: MH
authors.lastname: Murad
authors.affiliation: Departments of Radiology (B.G.).
authors.forename: B
authors.identifier: http://orcid.org/0000-0003-1504-1377
authors.initials: B
authors.lastname: Glodny
authors.affiliation: From the Departments of Neurologic Surgery (O.P., G.L.).|Radiology (W.B., G.L.).
authors.forename: G
authors.identifier: http://orcid.org/0000-0003-1479-465X
authors.initials: G
authors.lastname: Lanzino
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon / Q000379:methods*; D016893:Carotid Stenosis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D018579:Patient Selection; D015607:Stents; D016896:Treatment Outcome