Document Detail


Meta-analysis of allograft bypass grafting to infrapopliteal arteries.
MedLine Citation:
PMID:  15465366     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine graft patency and limb preservation after allograft bypass grafting to infrapopliteal arteries for different allograft materials. DESIGN: Meta-analysis of case series that used survival analysis to describe outcomes. METHODS: Studies published from 1982 through 2003 were identified from electronic databases and pertinent original articles. Four series of cryopreserved arterial allografts, 10 series of cryopreserved vein allografts, three series of cold-storaged vein allografts, and 16 series of umbilical-cord vein allografts were included in separate random-effects meta-analyses. RESULTS: A graphical display of pooled survival curves of graft patency showed cold-storaged veins to have the best outcome in the first 4 years, followed by cryopreserved arteries, umbilical-cord veins, and cryopreserved veins. The respective 5-year pooled patency were 24, 21, 30, and 19%. For foot preservation, the best outcome was achieved with cryopreserved arteries followed by cryopreserved veins, umbilical-cord veins, and cold-storaged veins. A reference meta-analysis of polytetrafluoroethlylene grafts occupied the top position for graft patency and the second position for foot preservation. CONCLUSION: In leg revascularisation for critical ischaemia, graft patency is poor for allografts generally, but using peripheral allografts in repeat attempts at revascularisation is a valid strategy to prevent major amputation. A role for umbilical-cord vein allografts remains uncertain.
Authors:
M Albers; M Romiti; C A B Pereira; M Antonini; M Wulkan
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Publication Detail:
Type:  Comparative Study; Journal Article; Meta-Analysis    
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  28     ISSN:  1078-5884     ISO Abbreviation:  Eur J Vasc Endovasc Surg     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2004-10-06     Completed Date:  2005-03-31     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  462-72     Citation Subset:  IM    
Affiliation:
Vascular Surgery Section, Department of Surgery, University of São Paulo Medical School, São Paulo, SP, Brazil. albersm@uol.com.br
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MeSH Terms
Descriptor/Qualifier:
Arterial Occlusive Diseases / surgery*
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation / methods*
Graft Occlusion, Vascular
Humans
Ischemia / surgery*
Leg / blood supply*
Limb Salvage
Popliteal Artery / surgery*
Vascular Patency

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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