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Updated: Aug 23, 2026
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Effect of stents in reducing restenosis in small coronary arteries: a meta-analysis
1Cardiology Division, University of Illinois at Chicago, Chicago, Illinois, USA. pvaitkus@uic.edu
Abstract:
The ability of stents to reduce restenosis was established in larger coronary arteries. Clinical trials of stenting in smaller vessels have yielded conflicting results due in part to their sample sizes. The aim of this meta-analysis was to increase the statistical power by pooling data from these clinical trials. Trials were identified from Medline search, review of recent cardiology meetings' abstracts, and manual review of bibliographies. Studies were included if they were prospective randomized controlled trials. Endpoints examined included a dichotomized definition of angiographic restenosis, target lesion revascularization (TLR), target vessel revascularization (TVR), or any repeat revascularization. Pooling of data was performed by calculating a Mantel-Haenszel odds ratio (OR). The analysis included 2,598 patients enrolled in eight clinical trials. Stenting significantly reduced restenosis (OR = 0.62; 95% CI = 0.61-0.63). Concordantly, stenting reduced TLR (OR = 0.49), TVR (OR = 0.90), and any revascularization (OR = 0.48). This meta-analysis supports the hypothesis that stenting reduces restenosis in small coronary arteries as well as in larger coronary arteries. The apparent discordant result of individual clinical trials was due in part to underpowering related to small sample sizes.
Insights
Stenting effectively reduces restenosis in small coronary arteries, overcoming limitations of previous small studies. This meta-analysis confirms stenting
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Medical Technology Evaluation
Background:
- Stent efficacy in reducing restenosis is proven in large coronary arteries.
- Conflicting results exist for stenting in smaller vessels, often due to small sample sizes.
- Meta-analysis is needed to pool data and increase statistical power for small vessel stenting outcomes.
Purpose of the Study:
- To determine the efficacy of stenting in reducing restenosis in small coronary arteries.
- To increase statistical power by pooling data from existing clinical trials.
- To provide a definitive conclusion on stenting outcomes in small coronary vessels.
Main Methods:
- Systematic literature search of Medline and cardiology meeting abstracts.
- Inclusion of prospective randomized controlled trials.
- Meta-analysis using Mantel-Haenszel odds ratio (OR) on pooled data from 2,598 patients in eight trials.
Main Results:
- Stenting significantly reduced angiographic restenosis (OR = 0.62).
- Stenting also reduced target lesion revascularization (TLR) (OR = 0.49) and any repeat revascularization (OR = 0.48).
- Target vessel revascularization (TVR) was also reduced (OR = 0.90).
Conclusions:
- Stenting is effective in reducing restenosis in small coronary arteries, similar to larger vessels.
- The meta-analysis supports the hypothesis that stenting benefits small coronary arteries.
- Underpowered individual trials likely contributed to conflicting results in prior studies.
