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Drug-coated balloon, drug-eluting stent, versus bare-metal stent for vertebral artery ostial stenosis: a systematic review and network meta-analysis 期刊论文

编号：

25FB9C8BE90498279C6A77BCAD54A530
作者：

Li, Zhiqiang(李志强)#^[1]Wu, Shuhui^[2];Wu, Chao^[3];Yin, Yue^[3];Xu, Xiaofan(徐晓帆)*^[1]
语种：

英文
期刊：

FRONTIERS IN NEUROLOGY ISSN：1664-2295 2026 年 17 卷 ; OCT 8
收录：
关键词：

bare-metal stent drug-coated balloon drug-eluting stent endovascular treatment network meta-analysis restenosis vertebral artery ostial stenosis
摘要：

Background: Stenosis at the origin of the vertebral artery (VAOS) accounts for approximately one in five posterior circulation ischemic events. Bare-metal stents (BMS) have been the conventional endovascular treatment, but restenosis occurs in 11-67% of cases. Drug-coated balloons (DCB) and drug-eluting stents (DES) are alternative strategies; however, no network meta-analysis has compared all three modalities specifically at the vertebral origin.
Methods: Five databases-PubMed, Embase, Cochrane CENTRAL, CNKI, and Wanfang-were searched from 2010 through May 2026 for studies comparing at least two of DCB, DES, or BMS in adults with symptomatic VAOS. The search identified 499 records; 393 underwent title and abstract screening after deduplication, from which 60 full-text articles were assessed. A frequentist random-effects network meta-analysis was conducted using the netmeta package (R 4.5.2), with Bayesian sensitivity analysis. The primary endpoint was imaging-confirmed restenosis (>= 50%). The protocol was registered with PROSPERO (CRD420261413981).
Results: Seven studies (three randomized trials and four observational cohorts, N = 970; range 46-217) met the inclusion criteria. Compared with BMS, both DES (OR 0.27, 95% CI 0.17-0.45) and DCB (OR 0.39, 95% CI 0.18-0.83) reduced restenosis. DES and DCB did not differ significantly from each other (OR 1.42, 95% CI 0.58-3.50). Between-study heterogeneity was modest (I-2 = 20.5%). Although the point estimate suggests modest heterogeneity, the wide confidence interval and the small number of studies limit precision. Low I-2 in a small network should not be equated with clinical homogeneity. P-scores ranked DES first (88.9%), DCB second (60.7%), and BMS last (0.4%). For perioperative safety, DCB ranked highest (P-score 90.0%).
Conclusion: Both DES and DCB reduce restenosis compared with BMS in VAOS. Both DES and DCB are associated with lower restenosis rates than BMS. The relative anti-restenosis efficacy of DES versus DCB remains uncertain due to the absence of direct head-to-head comparisons. Treatment selection should be individualized based on lesion characteristics and procedural considerations. The DCB evidence base remains small, and head-to-head comparisons of DES versus DCB at the vertebral origin are needed.
Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261413981, Identifier: CRD420261413981.
推荐引用方式
GB/T 7714：

Li Zhiqiang,Wu Shuhui,Wu Chao, et al. Drug-coated balloon, drug-eluting stent, versus bare-metal stent for vertebral artery ostial stenosis: a systematic review and network meta-analysis [J].FRONTIERS IN NEUROLOGY,2026,17.
APA：

Li Zhiqiang,Wu Shuhui,Wu Chao,Yin Yue,&Xu Xiaofan.(2026).Drug-coated balloon, drug-eluting stent, versus bare-metal stent for vertebral artery ostial stenosis: a systematic review and network meta-analysis .FRONTIERS IN NEUROLOGY,17.
MLA：

Li Zhiqiang, et al. "Drug-coated balloon, drug-eluting stent, versus bare-metal stent for vertebral artery ostial stenosis: a systematic review and network meta-analysis" .FRONTIERS IN NEUROLOGY 17(2026).
入库时间：

11/1/2026 9:56:37 PM
更新时间：

11/1/2026 9:56:37 PM

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