Major clinical outcomes of stent or balloon angioplasty: A systematic review of successful reperfusion analysis

Author(s): Otavio Queiroz Assumpcao, Vanessa Piovesan Freitas Assumpcao, Francisco Correa de Almeida Moraes, Ulisses Moraes Goncalves, Antonio Carlos Broim Pancotti, Marcela Dias Azem de Figueiredo, Daniel Dias Azem, Elaine Cristina Maitan Alves, Idiberto Jose Zotarelli Filho

Introduction: According to the World Health Organization (WHO), Cardiovascular Disease (CVD) is the leading cause of death in the world, and in Brazil, CVD is responsible for about 384 thousand deaths per year. In percutaneous coronary intervention, the successful treatment of the coronary lesion is primarily associated with its effective clearance through dilation and/or treatment by some percutaneous device. With the advent of metallic stents and, consequently, the elimination of the phenomenon of immediate elastic retraction of the vessel, there were quite reduced residual stenosis measures concerning those obtained with balloon procedures only.

Objective: It was to highlight the main clinical outcomes of stent or balloon angioplasty through a systematic review of successful reperfusion analysis.

Methods: The rules of the Systematic Review-PRISMA Platform were followed. The research was carried out from February 2022 to June 2022 and developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument.

Results: A total of 108 articles were found. In total, 68 articles were fully evaluated and 23 were included and evaluated in this study. And of the total of 23 articles, only 09 articles were developed as the main clinical results. Of the initial total of articles, 16 articles were excluded because they did not meet the GRADE classification, and 45 were excluded because they presented a risk of bias. The results suggest that, even in the era of stents, the analysis of complex lesion morphology can serve as a result stratified, helping in decision making since it significantly impacts late clinical evolution. Also, carotid artery stenting and a retrograde approach had greater odds of successful reperfusion and good functional outcomes at 3 months than balloon angioplasty and an anterograde approach.

Conclusion: The clinical outcomes of angioplasty with a stent showed successful reperfusion concerning the use of the balloon, favoring a faster recovery of patients for hospital discharge.