Abstract

Drug-eluting stents (DESs) have become the first-line treatment for symptomatic peripheral arterial disease (PAD). Currently, there are many types of DESs on the market. The same type of DESs has different concentrations, and various drugs in them show uneven efficacy. The selection of DESs remains controversial. This study was aimed at comparing the long-term real-world outcomes of different DESs in the treatment of peripheral arterial occlusive disease (PAOD). The databases including Cochrane Library, Embase, and PubMed were searched with a time frame until March 25, 2023. The primary patency (PP) and target lesion revascularization (TLR) at 6 months were used as the primary endpoints. A total of 32 studies (5467 patients) were eligible. At the six-month follow-up, DES-Evero 1 ug/mm2 ranked first in terms of PP, with a significant difference from BMSs (RR [95% CI] = 1.6). DES-Siro 0.9 ug/mm2, DES-Siro 1.4 ug/mm2, DES-Siro 1.95 ug/mm2, DES-PTX 0.167 ug/mm2, DES-PTX 1 ug/mm2 and covered stents (CSs) showed significantly better PPs than BMSs. In terms of TLR, DES-Siro 0.9 ug/mm2 (0.31) ranked first, and DES-Evero 1 ug/mm2 ranked last. Among the treatment modalities for PAD, different DESs showed overall encouraging results in improving PP and TLR compared with BMSs. DES-Evero 1 ug/mm2 showed the best PP, but it had the highest reintervention rate at 6 months. Sirolimus-eluting stents were not always more effective with higher concentrations of sirolimus. Among various DESs, sirolimus-eluting stents and everolimus-eluting stents were superior to paclitaxel-eluting stents.

中文翻译：

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外周动脉疾病药物洗脱支架中的不同药物：系统评价和贝叶斯荟萃分析

摘要

药物洗脱支架（DES）已成为症状性外周动脉疾病（PAD）的一线治疗方法。目前，市场上有多种类型的 DES。同一类型的DES具有不同的浓度，其中各种药物的疗效参差不齐。DES 的选择仍然存在争议。本研究旨在比较不同 DES 治疗外周动脉闭塞性疾病 (PAOD) 的长期现实结果。检索的数据库包括 Cochrane Library、Embase 和 PubMed，时间范围截至 2023 年 3 月 25 日。以 6 个月时的主要通畅率（PP）和靶病灶血运重建（TLR）作为主要终点。共有 32 项研究（5467 名患者）符合资格。在六个月的随访中，DES-Evero 1 ug/mm2 在 PP 方面排名第一，与 BMS 存在显着差异（RR [95% CI] = 1.6）。DES-Siro 0.9 ug/mm2、DES-Siro 1.4 ug/mm2、DES-Siro 1.95 ug/mm2、DES-PTX 0.167 ug/mm2、DES-PTX 1 ug/mm2 和覆膜支架 (CS) 的 PP 明显优于BMS。在TLR方面，DES-Siro 0.9 ug/mm2（0.31）排名第一，DES-Evero 1 ug/mm2排名最后。在 PAD 的治疗方式中，与 BMS 相比，不同的 DES 在改善 PP 和 TLR 方面显示出总体令人鼓舞的结果。DES-Evero 1 ug/mm2 显示出最佳的 PP，但其在 6 个月时的再干预率最高。西罗莫司洗脱支架并不总是在西罗莫司浓度较高时更有效。在各种DES中，西罗莫司洗脱支架和依维莫司洗脱支架优于紫杉醇洗脱支架。