A meta-analysis of the safety and efficacy of intravascular lithotripsy for the treatment of lower limb peripheral artery disease
10.3760/cma.j.cn112149-20250222-00095
- VernacularTitle:血管内碎石术治疗下肢外周动脉疾病安全性与有效性的Meta分析
- Author:
Yongqi LI
1
;
Hai ZHOU
;
Ganggang WANG
;
Liulan QIAN
;
Zhongzhi JIA
Author Information
1. 南京医科大学第三附属医院介入血管科，常州 213003
- Publication Type:Journal Article
- Keywords:
Lithotripsy;
Peripheral arterial disease;
Treatment outcome;
Validation studies;
Meta-analysis
- From:
Chinese Journal of Radiology
2025;59(9):1071-1077
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the efficacy and safety of intravascular lithotripsy (IVL) for the treatment of calcified lesions in lower limb peripheral artery disease (PAD).Methods:A literature search was conducted on PubMed, Web of Science, Cochrane Library, and Embase, including studies related to IVL for calcified lesions in PAD published from January 2016 to December 2024. Data on patient baseline characteristics, lesion information, IVL procedural parameters, changes in vascular stenosis, and complication occurrence were extracted and included. The Methodological Index for Non-Randomized Studies (MINORS) was used to assess the quality of the included studies. The meta-analysis was performed using STATA 15.1 software. The heterogeneity of different studies was evaluated using Cochran′s Q test. The publication bias was assessed through funnel plots and Egger test.Results:A total of nine studies were included (1 983 patients, 2 387 lesions). The meta-analysis demonstrated that regarding efficacy, after IVL treatment, the average reduction in vascular stenosis was 52.1% (95% CI 45.3%-58.9%). Regarding safety, the incidence of flow-limiting dissection was only 0.6% (95% CI 0.1%-1.4%), and the perforation rate was 0.4%-0.5%, with no events of severe amputation or death. In combined treatments, the usage rate of drug-coated balloons reached 51.2%, and the stent implantation rate was 20.4%. Conclusions:IVL can effectively reduce the degree of vascular stenosis in calcified lesions and has a high safety profile. Combined treatment with drug-coated balloons can reduce the dependence on stents.
