Document Detail


Meta-analysis of alternate autologous vein bypass grafts to infrapopliteal arteries.
MedLine Citation:
PMID:  16171586     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Several studies have described acceptable results for infrapopliteal bypass surgery that uses an autogenous vein other than the greater saphenous vein but is still no reliable prediction of outcomes. The objective of this study was to use meta-analysis to assess the long-term outcomes after infrapopliteal bypass grafting done with alternate autologous veins.
METHODS: Studies published from 1982 through 2004 were identified from electronic databases and pertinent original articles. Thirty-two series were selected, all of which had used survival analysis and had reported a 1-year graft patency rate, with at least 15 bypasses. An interval success rate was calculated for each month in each series of grafts by using data from life tables, survival curves, and texts. Monthly success rates were combined across series to obtain a pooled estimate of success for each month. Pooled survival curves were then constructed for graft patency and foot preservation.
RESULTS: The 5-year pooled estimates were 46.9% (95% confidence interval [CI] = 35.5%-58.3%) for primary patency, 66.5% (95% CI = 54.9%-78.2%) for secondary patency, and 76.4% (95% CI = 68.0%-84.8%) for foot preservation. These results were far superior to those reported for nonautologous grafts. Intensive duplex surveillance had a favorable impact on graft patency and foot preservation. No publication bias was detected.
CONCLUSIONS: When the greater saphenous vein is unavailable, alternate autologous veins are preferable to other graft materials in bypass surgery to infrapopliteal arteries.
Authors:
Maximiano Albers; Marcello Romiti; Francisco Cardoso Brochado-Neto; Carlos Alberto Bragança Pereira
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Publication Detail:
Type:  Journal Article; Meta-Analysis    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  42     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2005 Sep 
Date Detail:
Created Date:  2005-09-20     Completed Date:  2005-10-20     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  449-55     Citation Subset:  IM    
Affiliation:
Vascular Surgery Section, Department of Surgery, Health and Medical Sciences Sector, Lusiada Foundation, Santos, SP, Brazil. albersm@uol.com.br
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MeSH Terms
Descriptor/Qualifier:
Aged
Arterial Occlusive Diseases / surgery*
Female
Humans
Limb Salvage
Male
Middle Aged
Peripheral Vascular Diseases / surgery*
Popliteal Artery / surgery*
Survival Analysis
Transplantation, Autologous
Treatment Outcome
Vascular Patency
Veins / transplantation*

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


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