Graft type for femoro‐popliteal bypass surgery

摘要: Background Vascular surgeons construct femoro-popliteal bypass grafts, from the groin to knee, save limbs that might otherwise require amputation in patients with severe arterial disease, and improve walking distance less disease. During operation, blocked native artery is bypassed using either a section of patient's own vein (autologous vein), human umbilical (HUV), or an artificial graft e.g. Dacron polytetrafluoroethylene (PTFE). Objectives To determine most effective type for surgery. Search strategy The Cochrane Peripheral Vascular Diseases Group searched their Specialised Register, authors reference lists relevant articles, hand proceedings British European Surgical Societies North American Society Surgery. They also contacted all major manufacturers grafts published trials enquire about unpublished trials. Selection criteria Randomised comparing one another. Data collection analysis Both reviewers selected assessed trial quality independently. Main results Nine were included total 1334 participants. These investigated variety types. In above-knee grafting, primary secondary patency significantly better saphenous (73% 90%, respectively) compared PTFE (47%, p<0.05 47%, p<0.05) (54%, p<0.01 60%, p<0.01) at four years. Two in-situ reversed above- below-knee popliteal revealed no differences (64% v 62% respectively), (65% 70%), survival intact limb (74% both groups) five ten year follow-up. Three HUV showed rates HUV, (41% 73%, p<0.005; 49% 66%, p<0.05; 22% 42%,p=0.005) years (32% 65%, p<0.001). Comparison with, without, cuff found difference grafts. However, was higher plus (52% 29%, p=0.03) two years. Authors' conclusions There clear evidence which best grafting. In terms autologous patency, are equally successful, while performs than PTFE. A distal may