Abstract
Pulmonary vein stenosis (PVS) may arise from a variety of conditions resulting in major morbidity and mortality. In some patients, pharmacological therapy may help but more often in advanced stages, mechanical treatment must be considered. Transcatheter approaches, both Balloon Angioplasty (BA) and stent implantation have been applied. While both may be effective, they continue to be limited by restenosis. From 1/1/2010 to 8/2/2021, English language studies in humans were assessed in Ovid MEDLINE(R), Ovid Embase, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus. Two independent reviewers screened articles including those in which BA or stenting was performed for PVS with reporting of restenosis outcomes and data were independently extracted. Systematic review was performed, and overall restenosis rates were reported across all included studies. Meta-analysis was then performed using RevMan 5.4 assessing rates of restenosis and restenosis requiring re-intervention. Our systematic review yielded 4 studies, treating a total of 340 patients with 579 PV interventions (225 BA and 354 Stents, mean follow-up 13-69 months). Restenosis requiring repeat intervention was reported in 3 studies, including 301 patients with 495 PV interventions (157 BA and 338 Stents). Compared to BA, stenting was associated with both a lower risk of restenosis [RR 0.36, 95% CI (0.18, 0.73), p=0.005] and a lower risk of restenosis requiring re-intervention [RR 0.36, 95% CI (0.15, 0.86), p=0.02]. For PVS intervention, restenosis and re-intervention rates may be improved by stent implantation compared to BA.
ARYAN'S BLOG 