Systematic review and meta-analysis of vein cuffs for below-knee synthetic bypass
Article first published online: 22 MAY 2012
Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
British Journal of Surgery
Volume 99, Issue 9, pages 1195–1202, September 2012
How to Cite
Twine, C. P., Williams, I. M. and Fligelstone, L. J. (2012), Systematic review and meta-analysis of vein cuffs for below-knee synthetic bypass. Br J Surg, 99: 1195–1202. doi: 10.1002/bjs.8811
- Issue published online: 2 AUG 2012
- Article first published online: 22 MAY 2012
- Manuscript Accepted: 12 APR 2012
The aim was to investigate the possible benefit of vein cuffs for femoral to below-knee popliteal and femorodistal vessel synthetic bypass grafts.
PubMed, the Cochrane library, Embase and ClinicalTrials.gov were searched for all studies on any clinical effect of vein cuffs on synthetic grafts. Outcomes were selected based on inclusion in two or more studies: primary patency and limb survival. The data were subjected to meta-analysis by outcome.
Three cohort and two randomized studies were selected for inclusion, involving 885 patients. Meta-analysis of five studies examining below-knee popliteal bypass showed a significant improvement for primary patency in cuffed grafts at 2 years, but not at 1 or 3 years (odds ratio at 2 years 0·46, 95 per cent confidence interval 0·22 to 0·97; P = 0·04). Limb salvage was significantly improved in cuffed grafts up to 2 years. Limb survival was also improved for cuffed distal grafts at 2 years (odds ratio 0·29, 0·11 to 0·75; P = 0·01) but showed no difference at any other time interval. Study quality was generally poor, with conflicting results.
There was a small but significant benefit for vein cuffs on synthetic grafts used for femoral to below-knee popliteal anastomoses, but little benefit for femorodistal anastomoses. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.