Systematic Review and Meta-Analysis of the Outcome of Different Treatments for Innominate Artery Stenosis or Occlusion

Angiology. 2024 Apr;75(4):314-322. doi: 10.1177/00033197231162179. Epub 2023 Mar 9.

Abstract

The present study reported the outcomes of different treatments for innominate artery (IA) atherosclerotic stenosis or occlusion. We performed a systematic review of the literature (4 database searched; last search February 2022), including articles with ≥5 patients. We performed meta-analyses of proportions for different postoperative outcomes. Fourteen studies were included (656 patients; 396 underwent surgery, 260 endovascular procedures). IA lesions were asymptomatic in 9.6% (95% CI 4.6-14.6). Overall estimated technical success (TS) rate was 91.7% (95% CI 86.9-96.4); weighted TS rate was 86.8% (95% CI 75-98.6) in the surgical group (SG), 97.1% (95% CI 94.6-99.7) in the endovascular group (EG). Postoperative stroke in SG was 2.5% (95% CI 1-4.1) and 2.1% in EG (95% CI .3-3.8). Overall, 30-day occlusion was estimated .9% (95% CI 0-1.8) in SG and .7% (95% CI 0-1.7) in EG. Thirty-day mortality was 3.4% (95% CI .9-5.8) in SG and .7% (95% CI 0-1.7) in EG. Estimated mean follow-up after intervention was 65.5 months (95% CI 45.5-85.5) in SG and 22.4 months (95% CI 14.72-30.16) in EG. During follow-up, restenosis in SG were 2.8% (95% CI .5-5.1) and 16.6% (95% CI 5- 28.1) in EG. In conclusion, the endovascular approach seems to offer good short to mid-term outcomes, but with a higher rate of restenosis during follow-up.

Keywords: atherosclerotic disease; endovascular; innominate artery; occlusion; open surgery; stenosis.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Aged
  • Arterial Occlusive Diseases* / surgery
  • Arterial Occlusive Diseases* / therapy
  • Brachiocephalic Trunk* / diagnostic imaging
  • Brachiocephalic Trunk* / surgery
  • Constriction, Pathologic
  • Endovascular Procedures* / adverse effects
  • Female
  • Humans
  • Male
  • Risk Factors
  • Stents
  • Stroke / etiology
  • Treatment Outcome