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Study flow diagram.
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Figure 1

Study flow diagram.

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Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
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Figure 2

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

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Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
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Figure 3

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

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Comparison 1 Balloon angioplasty versus medical therapy, Outcome 1 Change in systolic BP at 2 years or end of follow‐up.
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Analysis 1.1

Comparison 1 Balloon angioplasty versus medical therapy, Outcome 1 Change in systolic BP at 2 years or end of follow‐up.

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Comparison 1 Balloon angioplasty versus medical therapy, Outcome 2 Change in diastolic BP at 2 years or end of follow‐up.
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Analysis 1.2

Comparison 1 Balloon angioplasty versus medical therapy, Outcome 2 Change in diastolic BP at 2 years or end of follow‐up.

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Comparison 1 Balloon angioplasty versus medical therapy, Outcome 3 Serum creatinine at 2 years or end of follow up.
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Analysis 1.3

Comparison 1 Balloon angioplasty versus medical therapy, Outcome 3 Serum creatinine at 2 years or end of follow up.

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Comparison 1 Balloon angioplasty versus medical therapy, Outcome 4 Number of antihypertensive drugs.
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Analysis 1.4

Comparison 1 Balloon angioplasty versus medical therapy, Outcome 4 Number of antihypertensive drugs.

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Comparison 1 Balloon angioplasty versus medical therapy, Outcome 5 Cardiovascular adverse events.
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Analysis 1.5

Comparison 1 Balloon angioplasty versus medical therapy, Outcome 5 Cardiovascular adverse events.

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Comparison 1 Balloon angioplasty versus medical therapy, Outcome 6 Renal adverse events.
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Analysis 1.6

Comparison 1 Balloon angioplasty versus medical therapy, Outcome 6 Renal adverse events.

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Table 1. Cardiovascular complications

Complications

ASTRAL

CORAL

DRASTIC

EMMA

NITER

SNRASCG

STAR

Angina/myocardial infarction/heart failure

112 in BA, 131 in MT

40 in BA, 37 in MT

0 in BA, 2 in MT

0 in any group

Data not available

4 in each group

4 in BA, 6 in MT

(defined as

CAD + HF)

Cholesterol embolisation

3 in BA, 0 in MT

6 in BA, 0 in MT

0 in BA, 1 in MT

0 in any group

Data not available

0 in any group

1 in BA, 0 in MT

Non‐procedure‐related symptomatic hypotension

Data not available

Data not available

0 in any group

0 in BA, 1 in MT

Data not available

0 in any group

Data not available

Stroke

24 in BA, 23 in MT

16 in BA, 23 in MT

0 in any group

0 in any group

3 in BA, 4 in MT

1 in BA, 4 in MT

0 in BA, 1 in MT

(defined as cerebro

vascular disease)

Death

103 in BA, 106 in MT

63 in BA, 76 in MT

0 in any group

0 in any group

3 in BA, 3 in MT

2 in BA, 4 in MT

6 in MT, 5 in BA

BA: balloon angioplasty group
CAD: coronary artery disease
HF: heart failure
MT: medical therapy group

Figuras y tablas -
Table 1. Cardiovascular complications
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Table 2. Renovascular complications

Complications

ASTRAL

CORAL

DRASTIC

EMMA

NITER

SNRASCG

STAR

> 50% increase in serum creatinine

or
> 20% decrease in estimated creatinine clearance

Data not available

Data not available

1 in BA, 3 in MT

0 in BA, 1 in MT

Data not available

0 in any group

10 in BA, 16 in MT

(data provided for

20% fall in CrCl only)

Renal failure

55 in BA, 54 in MT

(defined as AKI + dialysis for

end stage renal disease)

16 in BA, 8 in MT (defined as permanent RRT)

0 in any group

0 in any group

10 in BA, 8 in MT

(but unclear how worsening

renal failure was defined)

2 in each group

Data not available

Total occlusion of stenotic artery

5 in BA, 4 in MT

Data not available

0 in BA, 4 in MT

0 in any group

Data not available

0 in any group

Data not available

AKI: acute kidney injury
BA: balloon angioplasty group
CrCl: creatinine clearance
MT: medical therapy group
RRT: renal replacement therapy

Figuras y tablas -
Table 2. Renovascular complications
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Comparison 1. Balloon angioplasty versus medical therapy

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Change in systolic BP at 2 years or end of follow‐up Show forest plot

5

1743

Mean Difference (IV, Fixed, 95% CI)

‐1.07 [‐3.45, 1.30]

2 Change in diastolic BP at 2 years or end of follow‐up Show forest plot

4

809

Mean Difference (IV, Fixed, 95% CI)

0.00 [‐3.72, ‐0.27]

3 Serum creatinine at 2 years or end of follow up Show forest plot

3

725

Mean Difference (IV, Fixed, 95% CI)

‐7.99 [‐22.60, 6.62]

4 Number of antihypertensive drugs Show forest plot

3

1717

Mean Difference (IV, Fixed, 95% CI)

‐0.18 [‐0.34, ‐0.03]

5 Cardiovascular adverse events Show forest plot

7

2110

Peto Odds Ratio (Peto, Fixed, 95% CI)

0.91 [0.75, 1.11]

6 Renal adverse events Show forest plot

7

2104

Peto Odds Ratio (Peto, Fixed, 95% CI)

1.02 [0.75, 1.38]
Figuras y tablas -
Comparison 1. Balloon angioplasty versus medical therapy
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