Endovascular balloon angioplasty versus stenting in patients with Takayasu arteritis

Background: Symptomatic or significant vascular lesions of Takayasu arteritis (TA) need interventions. Although percutaneous transluminal angioplasty with balloon is a less invasive and safe method, stent implantation in TA can be an alternative option. However, superiority between balloon angioplasty and stenting in TA is not conclusive. Methods: A meta-analysis comparing balloon angioplasty and stenting outcomes was performed using the MEDLINE and EMBASE databases. Results: A total of 7 studies on 266 patients and 316 lesions were included. Balloon angioplasty was performed in 186 lesions and stenting in 130 lesions. There were no significant differences in the incidence of both restenosis and other complications between balloon angioplasty and stenting [odds ratio (OR)=2.39, 95% confidence interval (CI)=0.66-8.66, P=.18; OR=1.80, 95% CI=0.49-6.65, P=.38, respectively]. In the renal arteries, the risk of restenosis in stenting was significantly higher than that in balloon angioplasty (OR=4.40, 95% CI=2.14-9.02, P<.001). The clinical efficacy of improving renal hypertension between balloon angioplasty and stenting at the renal artery lesions was similar (OR=0.65, 95% CI=0.28-1.51, P=.31); however, acute vascular complications were significantly fewer in stenting than in balloon angioplasty (OR=0.07, 95% CI=0.02-0.29, P<.001). Conclusion: This meta-analysis found that balloon angioplasty can yield better results in renal artery interventions than stenting. Nonetheless, it is desirable to avoid vessel dissections during balloon angioplasty, which can eventually require stent implantations.