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Cochrane Database of Systematic Reviews

تاثیر نوع گرافت در جراحی بای‌پس فمورو‐پوپلیتئال

Information

DOI:
https://doi.org/10.1002/14651858.CD001487.pub3Copy DOI
Database:
  1. Cochrane Database of Systematic Reviews
Version published:
  1. 11 February 2018see what's new
Type:
  1. Intervention
Stage:
  1. Review
Cochrane Editorial Group:
  1. Cochrane Vascular Group

Copyright:
  1. Copyright © 2018 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

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Authors

  • Graeme K Ambler

    South East Wales Vascular Network, Aneurin Bevan University Health Board, Newport, UK

    Division of Population Medicine, Cardiff University School of Medicine, Cardiff, UK

  • Christopher P Twine

    Correspondence to: South East Wales Vascular Network, Aneurin Bevan University Health Board, Newport, UK

    [email protected]

    Division of Population Medicine, Cardiff University School of Medicine, Cardiff, UK

Contributions of authors

GA: identified relevant trials, assessed quality for all included trials, extracted data and updated the text of review.

CT: identified relevant trials, assessed quality, extracted data, wrote text of previous version of review, and reviewed updated text.

Sources of support

Internal sources

  • No sources of support supplied

External sources

  • Chief Scientist Office, Scottish Government Health Directorates, The Scottish Government, UK.

    The editorial base of Cochrane Vascular is supported by the Chief Scientist Office.

Declarations of interest

GA: has declared that he previously held a National Institute for Health Research Academic clinical fellowship (2011‐2014) and that he received funds for a grant from Heath and Care Research Wales regarding research for patient and public benefit (grant number 1198); there are no known conflicts of interest with this review.

CT: has declared that he received money from Cook Medical for travel/accommodation/meeting expenses unrelated to this review and that he received funds for a grant from Heath and Care Research Wales regarding research for patient and public benefit (grant number 1198); there are no known conflicts of interest with this review.

Acknowledgements

We are grateful to Drs Cathryn Broderick, Marlene Stewart and Karen Welch for their invaluable help and assistance in the preparation of this review.

Version history

Published

Title

Stage

Authors

Version

2018 Feb 11

Graft type for femoro‐popliteal bypass surgery

Review

Graeme K Ambler, Christopher P Twine

https://doi.org/10.1002/14651858.CD001487.pub3

2010 May 12

Graft type for femoro‐popliteal bypass surgery

Review

Christopher P Twine, Alexander D McLain

https://doi.org/10.1002/14651858.CD001487.pub2

1999 Apr 26

Graft type for femoro‐popliteal bypass surgery

Review

Nizam Mamode, Roy N Scott

https://doi.org/10.1002/14651858.CD001487

Differences between protocol and review

For this update, the risk of bias in all included studies was assessed using Cochrane's 'Risk of bias' tool and a 'Summary of findings' table has been added.

We reworded the objective so to adhere better to the Cochane guidelines.

We amended the 'types of studies' to include all possible graft types.

We provided definitions of the outcomes primary and secondary patency.

We analysed and presented data into groups according to whether the distal anastomosis was above or below the knee.

Keywords

MeSH

PICOs

Population
Intervention
Comparison
Outcome

The PICO model is widely used and taught in evidence-based health care as a strategy for formulating questions and search strategies and for characterizing clinical studies or meta-analyses. PICO stands for four different potential components of a clinical question: Patient, Population or Problem; Intervention; Comparison; Outcome.

See more on using PICO in the Cochrane Handbook.

Study flow diagram.
Figures and Tables -
Figure 1

Study flow diagram.

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

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

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

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

Comparison 1 Above‐knee autologous vein versus all other graft materials, Outcome 1 Primary patency at 3 months.
Figures and Tables -
Analysis 1.1

Comparison 1 Above‐knee autologous vein versus all other graft materials, Outcome 1 Primary patency at 3 months.

Comparison 1 Above‐knee autologous vein versus all other graft materials, Outcome 2 Primary patency at 6 months.
Figures and Tables -
Analysis 1.2

Comparison 1 Above‐knee autologous vein versus all other graft materials, Outcome 2 Primary patency at 6 months.

Comparison 1 Above‐knee autologous vein versus all other graft materials, Outcome 3 Primary patency at 12 months.
Figures and Tables -
Analysis 1.3

Comparison 1 Above‐knee autologous vein versus all other graft materials, Outcome 3 Primary patency at 12 months.

Comparison 1 Above‐knee autologous vein versus all other graft materials, Outcome 4 Primary patency at 24 months.
Figures and Tables -
Analysis 1.4

Comparison 1 Above‐knee autologous vein versus all other graft materials, Outcome 4 Primary patency at 24 months.

Comparison 1 Above‐knee autologous vein versus all other graft materials, Outcome 5 Primary patency at 60 months.
Figures and Tables -
Analysis 1.5

Comparison 1 Above‐knee autologous vein versus all other graft materials, Outcome 5 Primary patency at 60 months.

Comparison 1 Above‐knee autologous vein versus all other graft materials, Outcome 6 Secondary patency at 3 months.
Figures and Tables -
Analysis 1.6

Comparison 1 Above‐knee autologous vein versus all other graft materials, Outcome 6 Secondary patency at 3 months.

Comparison 1 Above‐knee autologous vein versus all other graft materials, Outcome 7 Secondary patency at 6 months.
Figures and Tables -
Analysis 1.7

Comparison 1 Above‐knee autologous vein versus all other graft materials, Outcome 7 Secondary patency at 6 months.

Comparison 1 Above‐knee autologous vein versus all other graft materials, Outcome 8 Secondary patency at 12 months.
Figures and Tables -
Analysis 1.8

Comparison 1 Above‐knee autologous vein versus all other graft materials, Outcome 8 Secondary patency at 12 months.

Comparison 1 Above‐knee autologous vein versus all other graft materials, Outcome 9 Secondary patency at 24 months.
Figures and Tables -
Analysis 1.9

Comparison 1 Above‐knee autologous vein versus all other graft materials, Outcome 9 Secondary patency at 24 months.

Comparison 1 Above‐knee autologous vein versus all other graft materials, Outcome 10 Secondary patency at 60 months.
Figures and Tables -
Analysis 1.10

Comparison 1 Above‐knee autologous vein versus all other graft materials, Outcome 10 Secondary patency at 60 months.

Comparison 2 Above‐knee PTFE versus all other graft materials, Outcome 1 Primary patency at 3 months.
Figures and Tables -
Analysis 2.1

Comparison 2 Above‐knee PTFE versus all other graft materials, Outcome 1 Primary patency at 3 months.

Comparison 2 Above‐knee PTFE versus all other graft materials, Outcome 2 Primary patency at 6 months.
Figures and Tables -
Analysis 2.2

Comparison 2 Above‐knee PTFE versus all other graft materials, Outcome 2 Primary patency at 6 months.

Comparison 2 Above‐knee PTFE versus all other graft materials, Outcome 3 Primary patency at 12 months.
Figures and Tables -
Analysis 2.3

Comparison 2 Above‐knee PTFE versus all other graft materials, Outcome 3 Primary patency at 12 months.

Comparison 2 Above‐knee PTFE versus all other graft materials, Outcome 4 Primary patency at 24 months.
Figures and Tables -
Analysis 2.4

Comparison 2 Above‐knee PTFE versus all other graft materials, Outcome 4 Primary patency at 24 months.

Comparison 2 Above‐knee PTFE versus all other graft materials, Outcome 5 Primary patency at 60 months.
Figures and Tables -
Analysis 2.5

Comparison 2 Above‐knee PTFE versus all other graft materials, Outcome 5 Primary patency at 60 months.

Comparison 2 Above‐knee PTFE versus all other graft materials, Outcome 6 Secondary patency at 3 months.
Figures and Tables -
Analysis 2.6

Comparison 2 Above‐knee PTFE versus all other graft materials, Outcome 6 Secondary patency at 3 months.

Comparison 2 Above‐knee PTFE versus all other graft materials, Outcome 7 Secondary patency at 6 months.
Figures and Tables -
Analysis 2.7

Comparison 2 Above‐knee PTFE versus all other graft materials, Outcome 7 Secondary patency at 6 months.

Comparison 2 Above‐knee PTFE versus all other graft materials, Outcome 8 Secondary patency at 12 months.
Figures and Tables -
Analysis 2.8

Comparison 2 Above‐knee PTFE versus all other graft materials, Outcome 8 Secondary patency at 12 months.

Comparison 2 Above‐knee PTFE versus all other graft materials, Outcome 9 Secondary patency at 24 months.
Figures and Tables -
Analysis 2.9

Comparison 2 Above‐knee PTFE versus all other graft materials, Outcome 9 Secondary patency at 24 months.

Comparison 2 Above‐knee PTFE versus all other graft materials, Outcome 10 Secondary patency at 60 months.
Figures and Tables -
Analysis 2.10

Comparison 2 Above‐knee PTFE versus all other graft materials, Outcome 10 Secondary patency at 60 months.

Comparison 2 Above‐knee PTFE versus all other graft materials, Outcome 11 Limb salvage at 1 month.
Figures and Tables -
Analysis 2.11

Comparison 2 Above‐knee PTFE versus all other graft materials, Outcome 11 Limb salvage at 1 month.

Comparison 2 Above‐knee PTFE versus all other graft materials, Outcome 12 Limb salvage at 24 months.
Figures and Tables -
Analysis 2.12

Comparison 2 Above‐knee PTFE versus all other graft materials, Outcome 12 Limb salvage at 24 months.

Comparison 3 Above‐knee heparin bonded Dacron versus all other graft materials, Outcome 1 Primary patency at 12 months.
Figures and Tables -
Analysis 3.1

Comparison 3 Above‐knee heparin bonded Dacron versus all other graft materials, Outcome 1 Primary patency at 12 months.

Comparison 3 Above‐knee heparin bonded Dacron versus all other graft materials, Outcome 2 Primary patency at 24 months.
Figures and Tables -
Analysis 3.2

Comparison 3 Above‐knee heparin bonded Dacron versus all other graft materials, Outcome 2 Primary patency at 24 months.

Comparison 3 Above‐knee heparin bonded Dacron versus all other graft materials, Outcome 3 Primary patency at 60 months.
Figures and Tables -
Analysis 3.3

Comparison 3 Above‐knee heparin bonded Dacron versus all other graft materials, Outcome 3 Primary patency at 60 months.

Comparison 4 Above‐knee externally supported graft versus unsupported graft materials, Outcome 1 Primary patency at 6 months.
Figures and Tables -
Analysis 4.1

Comparison 4 Above‐knee externally supported graft versus unsupported graft materials, Outcome 1 Primary patency at 6 months.

Comparison 4 Above‐knee externally supported graft versus unsupported graft materials, Outcome 2 Primary patency at 12 months.
Figures and Tables -
Analysis 4.2

Comparison 4 Above‐knee externally supported graft versus unsupported graft materials, Outcome 2 Primary patency at 12 months.

Comparison 4 Above‐knee externally supported graft versus unsupported graft materials, Outcome 3 Primary patency at 24 months.
Figures and Tables -
Analysis 4.3

Comparison 4 Above‐knee externally supported graft versus unsupported graft materials, Outcome 3 Primary patency at 24 months.

Comparison 4 Above‐knee externally supported graft versus unsupported graft materials, Outcome 4 Secondary patency at 6 months.
Figures and Tables -
Analysis 4.4

Comparison 4 Above‐knee externally supported graft versus unsupported graft materials, Outcome 4 Secondary patency at 6 months.

Comparison 4 Above‐knee externally supported graft versus unsupported graft materials, Outcome 5 Secondary patency at 12 months.
Figures and Tables -
Analysis 4.5

Comparison 4 Above‐knee externally supported graft versus unsupported graft materials, Outcome 5 Secondary patency at 12 months.

Comparison 4 Above‐knee externally supported graft versus unsupported graft materials, Outcome 6 Secondary patency at 24 months.
Figures and Tables -
Analysis 4.6

Comparison 4 Above‐knee externally supported graft versus unsupported graft materials, Outcome 6 Secondary patency at 24 months.

Comparison 5 Above‐knee polyurethane (PUR) versus all other graft materials, Outcome 1 Primary patency at 3 months.
Figures and Tables -
Analysis 5.1

Comparison 5 Above‐knee polyurethane (PUR) versus all other graft materials, Outcome 1 Primary patency at 3 months.

Comparison 5 Above‐knee polyurethane (PUR) versus all other graft materials, Outcome 2 Primary patency at 6 months.
Figures and Tables -
Analysis 5.2

Comparison 5 Above‐knee polyurethane (PUR) versus all other graft materials, Outcome 2 Primary patency at 6 months.

Comparison 5 Above‐knee polyurethane (PUR) versus all other graft materials, Outcome 3 Primary patency at 12 months.
Figures and Tables -
Analysis 5.3

Comparison 5 Above‐knee polyurethane (PUR) versus all other graft materials, Outcome 3 Primary patency at 12 months.

Comparison 5 Above‐knee polyurethane (PUR) versus all other graft materials, Outcome 4 Secondary patency at 3 months.
Figures and Tables -
Analysis 5.4

Comparison 5 Above‐knee polyurethane (PUR) versus all other graft materials, Outcome 4 Secondary patency at 3 months.

Comparison 5 Above‐knee polyurethane (PUR) versus all other graft materials, Outcome 5 Secondary patency at 6 months.
Figures and Tables -
Analysis 5.5

Comparison 5 Above‐knee polyurethane (PUR) versus all other graft materials, Outcome 5 Secondary patency at 6 months.

Comparison 5 Above‐knee polyurethane (PUR) versus all other graft materials, Outcome 6 Secondary patency at 12 months.
Figures and Tables -
Analysis 5.6

Comparison 5 Above‐knee polyurethane (PUR) versus all other graft materials, Outcome 6 Secondary patency at 12 months.

Comparison 6 Below‐knee PTFE versus all other graft materials, Outcome 1 Primary patency at 6 months.
Figures and Tables -
Analysis 6.1

Comparison 6 Below‐knee PTFE versus all other graft materials, Outcome 1 Primary patency at 6 months.

Comparison 6 Below‐knee PTFE versus all other graft materials, Outcome 2 Primary patency at 12 months.
Figures and Tables -
Analysis 6.2

Comparison 6 Below‐knee PTFE versus all other graft materials, Outcome 2 Primary patency at 12 months.

Comparison 6 Below‐knee PTFE versus all other graft materials, Outcome 3 Primary patency at 24 months.
Figures and Tables -
Analysis 6.3

Comparison 6 Below‐knee PTFE versus all other graft materials, Outcome 3 Primary patency at 24 months.

Comparison 6 Below‐knee PTFE versus all other graft materials, Outcome 4 Primary patency at 36 months.
Figures and Tables -
Analysis 6.4

Comparison 6 Below‐knee PTFE versus all other graft materials, Outcome 4 Primary patency at 36 months.

Comparison 6 Below‐knee PTFE versus all other graft materials, Outcome 5 Secondary patency at 3 months.
Figures and Tables -
Analysis 6.5

Comparison 6 Below‐knee PTFE versus all other graft materials, Outcome 5 Secondary patency at 3 months.

Comparison 6 Below‐knee PTFE versus all other graft materials, Outcome 6 Secondary patency at 6 months.
Figures and Tables -
Analysis 6.6

Comparison 6 Below‐knee PTFE versus all other graft materials, Outcome 6 Secondary patency at 6 months.

Comparison 6 Below‐knee PTFE versus all other graft materials, Outcome 7 Secondary patency at 12 months.
Figures and Tables -
Analysis 6.7

Comparison 6 Below‐knee PTFE versus all other graft materials, Outcome 7 Secondary patency at 12 months.

Comparison 6 Below‐knee PTFE versus all other graft materials, Outcome 8 Secondary patency at 24 months.
Figures and Tables -
Analysis 6.8

Comparison 6 Below‐knee PTFE versus all other graft materials, Outcome 8 Secondary patency at 24 months.

Comparison 6 Below‐knee PTFE versus all other graft materials, Outcome 9 Secondary patency at 36 months.
Figures and Tables -
Analysis 6.9

Comparison 6 Below‐knee PTFE versus all other graft materials, Outcome 9 Secondary patency at 36 months.

Comparison 6 Below‐knee PTFE versus all other graft materials, Outcome 10 Limb salvage at 12 months.
Figures and Tables -
Analysis 6.10

Comparison 6 Below‐knee PTFE versus all other graft materials, Outcome 10 Limb salvage at 12 months.

Comparison 6 Below‐knee PTFE versus all other graft materials, Outcome 11 Limb salvage at 24 months.
Figures and Tables -
Analysis 6.11

Comparison 6 Below‐knee PTFE versus all other graft materials, Outcome 11 Limb salvage at 24 months.

Comparison 7 Below‐knee heparin bonded Dacron versus all other graft materials, Outcome 1 Primary patency at 3 months.
Figures and Tables -
Analysis 7.1

Comparison 7 Below‐knee heparin bonded Dacron versus all other graft materials, Outcome 1 Primary patency at 3 months.

Comparison 7 Below‐knee heparin bonded Dacron versus all other graft materials, Outcome 2 Primary patency at 6 months.
Figures and Tables -
Analysis 7.2

Comparison 7 Below‐knee heparin bonded Dacron versus all other graft materials, Outcome 2 Primary patency at 6 months.

Comparison 7 Below‐knee heparin bonded Dacron versus all other graft materials, Outcome 3 Primary patency at 12 months.
Figures and Tables -
Analysis 7.3

Comparison 7 Below‐knee heparin bonded Dacron versus all other graft materials, Outcome 3 Primary patency at 12 months.

Comparison 7 Below‐knee heparin bonded Dacron versus all other graft materials, Outcome 4 Primary patency at 24 months.
Figures and Tables -
Analysis 7.4

Comparison 7 Below‐knee heparin bonded Dacron versus all other graft materials, Outcome 4 Primary patency at 24 months.

Comparison 7 Below‐knee heparin bonded Dacron versus all other graft materials, Outcome 5 Primary patency at 60 months.
Figures and Tables -
Analysis 7.5

Comparison 7 Below‐knee heparin bonded Dacron versus all other graft materials, Outcome 5 Primary patency at 60 months.

Summary of findings for the main comparison. Autologous vein compared to other graft types for above‐knee femoro‐popliteal bypass surgery

Autologous vein compared to other graft types for above‐knee femoro‐popliteal bypass surgery

Patient or population: people with peripheral vascular disease requiring above‐knee femoro‐popliteal bypass surgery
Setting: hospital
Intervention: autologous vein
Comparison: other graft types

Outcomes

Anticipated absolute effects* (95% CI)

Relative effect
(95% CI)

№ of limbs
(studies)

Quality of the evidence
(GRADE)

Comments

Risk with other graft types

Risk with autologous vein

Primary patency

(24 months)

Study population

OR 0.59
(0.37 to 0.94)

422
(4 RCTs)

⊕⊕⊝⊝
LOW 1 2

92 fewer autologous vein grafts per 1000 (10 to 152 grafts per 1000) lose primary patency by 24 months compared to other grafts studied

275 per 1000

183 per 1000
(123 to 263)

Primary patency

(60 months)

Study population

OR 0.47
(0.28 to 0.80)

269
(3 RCTs)

⊕⊕⊕⊝
MODERATE 3

172 fewer autologous vein grafts per 1000 (54 to 264 grafts per 1000) lose primary patency by 60 months compared to other grafts studied

451 per 1000

279 per 1000
(187 to 397)

Secondary patency

(60 months)

Study population

OR 0.41
(0.22 to 0.74)

176
(2 RCTs)

⊕⊕⊝⊝
LOW 1 2

213 fewer autologous vein grafts per 1000 (75 to 330 grafts per 1000) lose secondary patency by 60 months compared to other grafts studied

526 per 1000

313 per 1000
(196 to 451)

Limb salvage

No studies of these graft types reported on this outcome

*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).

CI: Confidence interval; OR: Odds ratio

GRADE Working Group grades of evidence
High quality: We are very confident that the true effect lies close to that of the estimate of the effect
Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect
Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect

1 Downgraded due to serious risk of bias resulting from lack of blinding and poor randomisation techniques
2 Downgraded due to imprecision because results based on small trials with few participants and events
3 Downgraded due to risk of bias resulting from lack of blinding and poor randomisation techniques. We did not downgrade further for imprecision because the effect was large and highly consistent between studies

Figures and Tables -
Summary of findings for the main comparison. Autologous vein compared to other graft types for above‐knee femoro‐popliteal bypass surgery
Summary of findings 2. PTFE compared to Dacron for above‐knee femoro‐popliteal bypass surgery

PTFE compared to Dacron for above‐knee femoro‐popliteal bypass surgery

Patient or population: people with peripheral vascular disease requiring above‐knee femoro‐popliteal bypass surgery
Setting: hospital
Intervention: PTFE
Comparison: Dacron

Outcomes

Anticipated absolute effects* (95% CI)

Relative effect
(95% CI)

№ of limbs
(studies)

Quality of the evidence
(GRADE)

Comments

Risk with Dacron

Risk with PTFE

Primary patency

(24 months)

Study population

OR 1.23
(0.92 to 1.65)

764
(4 RCTs)

⊕⊕⊝⊝
LOW 1 2

Our confidence in the effect is limited and this may differ substantially from the estimate of the effect

404 per 1000

454 per 1000
(384 to 528)

Primary patency

(60 months)

Study population

OR 1.67
(0.96 to 2.90)

247
(2 RCTs)

⊕⊕⊝⊝
LOW 1 2

Our confidence in the effect is limited and this may differ substantially from the estimate of the effect

606 per 1000

720 per 1000
(597 to 817)

Secondary patency

(24 months)

Study population

OR 1.54
(1.04 to 2.28)

528
(2 RCTs)

⊕⊕⊝⊝
LOW 1 2

81 more PTFE grafts per 1000 (7 to 168 per 1000) suffer from failed secondary patency by 24 months compared to Dacron

212 per 1000

293 per 1000
(219 to 380)

Limb salvage

(24 months)

Study population

OR 0.82
(0.27 to 2.48)

322
(1 RCT)

⊕⊕⊝⊝
LOW 1 2

Our confidence in the effect is limited and this may differ substantially from the estimate of the effect

44 per 1000

37 per 1000
(12 to 103)

*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).

CI: Confidence interval; OR: Odds ratio;PTFE: polytetrafluoroethylene

GRADE Working Group grades of evidence
High quality: We are very confident that the true effect lies close to that of the estimate of the effect
Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect
Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect

1 Downgraded because of serious risk of bias due to lack of blinding and poor randomisation techniques
2 Downgraded due to imprecision because of the low number of participants and events

Figures and Tables -
Summary of findings 2. PTFE compared to Dacron for above‐knee femoro‐popliteal bypass surgery
Summary of findings 3. Externally supported graft compared to unsupported graft for above‐knee femoro‐popliteal bypass surgery

Externally supported graft compared to unsupported graft for above‐knee femoro‐popliteal bypass surgery

Patient or population: people with peripheral vascular disease requiring above‐knee femoro‐popliteal bypass surgery
Setting: hospital
Intervention: externally supported graft
Comparison: unsupported graft

Outcomes

Anticipated absolute effects* (95% CI)

Relative effect
(95% CI)

№ of limbs
(studies)

Quality of the evidence
(GRADE)

Comments

Risk with unsupported graft

Risk with externally supported graft

Primary patency

(24 months)

Study population

OR 2.08
(1.29 to 3.35)

270
(2 RCTs)

⊕⊕⊝⊝
LOW 1 2

180 fewer unsupported prosthetic grafts per 1000 (61 to 293 grafts per 1000) lose primary patency by 24 months compared to externally supported prosthetic grafts

376 per 1000

556 per 1000
(437 to 669)

Primary patency

(60 months)

No studies comparing supported and unsupported Dacron reported on primary patency at 60 months

Secondary patency

(24 months)

Study population

OR 2.25
(1.24 to 4.07)

236
(1 RCT)

⊕⊕⊝⊝
LOW 1 2

143 fewer unsupported Dacron grafts per 1000 (32 to 281 grafts per 1,000) lose secondary patency by 24 months compared to externally supported Dacron grafts

165 per 1000

308 per 1000
(197 to 446)

Limb salvage

No studies of these graft types reported on this outcome

*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).

CI: Confidence interval; OR: Odds ratio;

GRADE Working Group grades of evidence
High quality: We are very confident that the true effect lies close to that of the estimate of the effect
Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect
Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect

1 Downgraded because of serious risk of bias due to lack of blinding and poor randomisation techniques
2 Downgraded due to imprecision because of the low number of participants and events

Figures and Tables -
Summary of findings 3. Externally supported graft compared to unsupported graft for above‐knee femoro‐popliteal bypass surgery
Summary of findings 4. PTFE compared to PTFE with vein cuff for below‐knee femoro‐popliteal bypass surgery

PTFE compared to PTFE with vein cuff for below‐knee femoro‐popliteal bypass surgery

Patient or population: people with peripheral vascular disease requiring below‐knee femoro‐popliteal bypass surgery
Setting: hospital
Intervention: PTFE
Comparison: PTFE with vein cuff

Outcomes

Anticipated absolute effects* (95% CI)

Relative effect
(95% CI)

№ of limbs
(studies)

Quality of the evidence
(GRADE)

Comments

Risk with PTFE with vein cuff

Risk with PTFE

Primary patency

(24 months)

Study population

OR 1.08
(0.58 to 2.01)

182
(2 RCTs)

⊕⊝⊝⊝
VERY LOW 1 2 3

Findings from two small trials were inconsistent so our confidence in the effect is limited and this may differ substantially from the estimate of the effect

626 per 1000

644 per 1000
(493 to 771)

Primary patency

(60 months)

No studies comparing PTFE with and without a vein cuff for below‐knee bypass reported on primary patency at 60 months

Secondary patency

(24 months)

Study population

OR 1.22
(0.67 to 2.23)

181
(2 RCTs)

⊕⊝⊝⊝
VERY LOW 1 2 3

Findings from two small trials were inconsistent so our confidence in the effect is limited and this may differ substantially from the estimate of the effect

557 per 1000

605 per 1000
(457 to 737)

Limb salvage

(24 months)

Study population

OR 1.34
(0.72 to 2.49)

196
(2 RCTs)

⊕⊕⊝⊝
LOW 1 3

Our confidence in the effect is limited and this may differ substantially from the estimate of the effect

266 per 1000

327 per 1000
(207 to 474)

*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).

CI: Confidence interval; OR: Odds ratio;

GRADE Working Group grades of evidence
High quality: We are very confident that the true effect lies close to that of the estimate of the effect
Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect
Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect

1 Downgraded due to serious risk of bias resulting from lack of blinding and poor randomisation techniques
2 Downgraded due to significant heterogeneity in studies
3 Downgraded due to imprecision because of the low number of participants and events

Figures and Tables -
Summary of findings 4. PTFE compared to PTFE with vein cuff for below‐knee femoro‐popliteal bypass surgery
Comparison 1. Above‐knee autologous vein versus all other graft materials

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary patency at 3 months Show forest plot

4

466

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

1.20 [0.58, 2.48]

1.1 Autologous vein v PTFE

2

249

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

1.27 [0.41, 3.97]

1.2 Autologous vein v other graft types

2

217

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

1.16 [0.45, 2.96]

2 Primary patency at 6 months Show forest plot

4

452

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

1.01 [0.56, 1.83]

2.1 Autologous vein v PTFE

2

245

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

1.12 [0.45, 2.78]

2.2 Autologous vein v other graft types

2

207

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

0.94 [0.43, 2.05]

3 Primary patency at 12 months Show forest plot

4

440

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

0.73 [0.44, 1.22]

3.1 Autologous vein v PTFE

2

238

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

0.81 [0.37, 1.76]

3.2 Autologous vein v other graft types

2

202

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

0.67 [0.34, 1.33]

4 Primary patency at 24 months Show forest plot

4

422

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

0.59 [0.37, 0.94]

4.1 Autologous vein vs PTFE

2

232

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

0.67 [0.34, 1.33]

4.2 Autologous vein vs other graft types

2

190

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

0.52 [0.28, 0.99]

5 Primary patency at 60 months Show forest plot

3

269

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

0.47 [0.28, 0.80]

5.1 Autologous vein v PTFE

2

191

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

0.48 [0.25, 0.95]

5.2 Autologous vein vs other graft type

1

78

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

0.44 [0.18, 1.07]

6 Secondary patency at 3 months Show forest plot

3

364

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

1.05 [0.47, 2.32]

6.1 Autologous vein v PTFE

1

147

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

1.08 [0.30, 3.87]

6.2 Autologous vein v other graft types

2

217

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

1.03 [0.37, 2.83]

7 Secondary patency at 6 months Show forest plot

3

351

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

0.95 [0.49, 1.82]

7.1 Autologous vein v PTFE

1

143

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

0.98 [0.36, 2.69]

7.2 Autologous vein v other graft types

2

208

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

0.92 [0.39, 2.19]

8 Secondary patency at 12 months Show forest plot

3

338

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

0.81 [0.45, 1.45]

8.1 Autologous vein v PTFE

1

136

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

0.99 [0.39, 2.51]

8.2 Autologous vein v other graft types

2

202

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

0.71 [0.34, 1.50]

9 Secondary patency at 24 months Show forest plot

3

320

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

0.70 [0.41, 1.19]

9.1 Autologous vein v PTFE

1

130

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

0.83 [0.37, 1.87]

9.2 Autologous vein v other graft type

2

190

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

0.62 [0.31, 1.24]

10 Secondary patency at 60 months Show forest plot

2

176

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

0.41 [0.22, 0.74]

10.1 Autologous vein v PTFE

1

98

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

0.44 [0.20, 0.99]

10.2 Autologous vein v other graft types

1

78

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

0.37 [0.15, 0.90]

Figures and Tables -
Comparison 1. Above‐knee autologous vein versus all other graft materials
Comparison 2. Above‐knee PTFE versus all other graft materials

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary patency at 3 months Show forest plot

2

312

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

2.36 [0.81, 6.87]

1.1 PTFE v HUV

1

93

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

1.55 [0.26, 9.33]

1.2 PTFE v Dacron

1

219

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

2.97 [0.78, 11.25]

2 Primary patency at 6 months Show forest plot

5

824

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

2.11 [1.37, 3.25]

2.1 PTFE v HUV

1

90

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

2.56 [0.69, 9.47]

2.2 PTFE v Dacron

2

421

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

1.57 [0.79, 3.11]

2.3 PTFE v PTFE with vein cuff

1

139

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

1.80 [0.57, 5.60]

2.4 PTFE v FUSION BIOLINE

1

174

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

2.99 [1.43, 6.26]

3 Primary patency at 12 months Show forest plot

6

1088

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

1.23 [0.93, 1.64]

3.1 PTFE v HUV

1

83

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

3.17 [1.04, 9.64]

3.2 PTFE v Dacron

4

875

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

1.24 [0.91, 1.70]

3.3 PTFE v PTFE with vein cuff

1

130

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

0.64 [0.26, 1.56]

4 Primary patency at 24 months Show forest plot

6

945

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

1.31 [1.00, 1.71]

4.1 PTFE V HUV

1

82

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

4.80 [1.76, 13.06]

4.2 PTFE V Dacron

4

764

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

1.23 [0.92, 1.65]

4.3 PTFE v PTFE with vein cuff

1

99

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

0.86 [0.37, 2.02]

5 Primary patency at 60 months Show forest plot

3

316

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

2.06 [1.28, 3.31]

5.1 PTFE v HUV

1

69

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

3.75 [1.46, 9.62]

5.2 PTFE v Dacron

2

247

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

1.67 [0.96, 2.90]

6 Secondary patency at 3 months Show forest plot

1

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

Totals not selected

6.1 PTFE v HUV

1

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

0.0 [0.0, 0.0]

7 Secondary patency at 6 months Show forest plot

2

318

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

1.32 [0.48, 3.62]

7.1 PTFE v HUV

1

93

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

1.76 [0.42, 7.44]

7.2 PTFE v Dacron

1

225

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

1.01 [0.25, 4.13]

8 Secondary patency at 12 months Show forest plot

4

806

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

1.18 [0.80, 1.74]

8.1 PTFE v HUV

1

93

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

1.60 [0.43, 5.89]

8.2 PTFE v Dacron

2

581

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

1.19 [0.76, 1.86]

8.3 PTFE v PTFE with vein cuff

1

132

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

0.99 [0.39, 2.52]

9 Secondary patency at 24 months Show forest plot

4

700

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

1.66 [1.18, 2.33]

9.1 PTFE V HUV

1

93

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

4.01 [1.44, 11.17]

9.2 PTFE v Dacron

2

528

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

1.54 [1.04, 2.28]

9.3 PTFE v PTFE with vein cuff

1

79

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

1.22 [0.48, 3.06]

10 Secondary patency at 60 months Show forest plot

2

260

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

2.86 [1.73, 4.72]

10.1 PTFE v HUV

1

93

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

3.87 [1.65, 9.05]

10.2 PTFE v Dacron

1

167

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

2.43 [1.31, 4.53]

11 Limb salvage at 1 month Show forest plot

2

560

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

0.68 [0.12, 3.98]

11.1 PTFE v Dacron

1

410

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

0.14 [0.01, 2.20]

11.2 PTFE v PTFE with vein cuff

1

150

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

2.02 [0.21, 19.72]

12 Limb salvage at 24 months Show forest plot

2

389

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

0.73 [0.33, 1.62]

12.1 PTFE v Dacron

1

322

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

0.82 [0.27, 2.48]

12.2 PTFE v PTFE with vein cuff

1

67

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

0.64 [0.20, 2.04]

Figures and Tables -
Comparison 2. Above‐knee PTFE versus all other graft materials
Comparison 3. Above‐knee heparin bonded Dacron versus all other graft materials

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary patency at 12 months Show forest plot

2

294

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

0.58 [0.34, 0.98]

1.1 HBD v HUV

1

123

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

0.47 [0.20, 1.12]

1.2 HBD v PTFE

1

171

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

0.65 [0.34, 1.25]

2 Primary patency at 24 months Show forest plot

2

282

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

0.62 [0.38, 1.02]

2.1 HBD v HUV

1

117

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

0.59 [0.26, 1.33]

2.2 HBD v PTFE

1

165

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

0.64 [0.34, 1.19]

3 Primary patency at 60 months Show forest plot

2

232

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

0.55 [0.33, 0.93]

3.1 HBD v HUV

1

86

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

1.07 [0.45, 2.51]

3.2 HBD v PTFE

1

146

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

0.38 [0.20, 0.72]

Figures and Tables -
Comparison 3. Above‐knee heparin bonded Dacron versus all other graft materials
Comparison 4. Above‐knee externally supported graft versus unsupported graft materials

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary patency at 6 months Show forest plot

2

299

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

1.28 [0.71, 2.31]

1.1 Externally supported dacron versus unsupported dacron

1

253

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

1.29 [0.69, 2.39]

1.2 Externally supported PTFE versus unsupported PTFE

1

46

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

1.21 [0.16, 9.25]

2 Primary patency at 12 months Show forest plot

2

286

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

1.78 [1.06, 2.98]

2.1 Externally supported dacron versus unsupported dacron

1

246

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

1.71 [0.99, 2.93]

2.2 Externally supported PTFE versus unsupported PTFE

1

40

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

2.73 [0.49, 15.28]

3 Primary patency at 24 months Show forest plot

2

270

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

2.08 [1.29, 3.35]

3.1 Externally supported dacron versus unsupported dacron

1

240

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

2.09 [1.26, 3.46]

3.2 Externally supported PTFE versus unsupported PTFE

1

30

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

2.01 [0.46, 8.76]

4 Secondary patency at 6 months Show forest plot

1

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

Totals not selected

5 Secondary patency at 12 months Show forest plot

1

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

Totals not selected

6 Secondary patency at 24 months Show forest plot

1

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

Totals not selected

Figures and Tables -
Comparison 4. Above‐knee externally supported graft versus unsupported graft materials
Comparison 5. Above‐knee polyurethane (PUR) versus all other graft materials

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary patency at 3 months Show forest plot

1

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

Totals not selected

2 Primary patency at 6 months Show forest plot

1

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

Totals not selected

3 Primary patency at 12 months Show forest plot

1

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

Totals not selected

4 Secondary patency at 3 months Show forest plot

1

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

Totals not selected

5 Secondary patency at 6 months Show forest plot

1

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

Totals not selected

6 Secondary patency at 12 months Show forest plot

1

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

Totals not selected

Figures and Tables -
Comparison 5. Above‐knee polyurethane (PUR) versus all other graft materials
Comparison 6. Below‐knee PTFE versus all other graft materials

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary patency at 6 months Show forest plot

4

319

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

1.12 [0.67, 1.87]

1.1 PTFE v ringed PTFE

1

44

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

1.47 [0.32, 6.71]

1.2 PTFE v PTFE with vein cuff

2

247

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

1.00 [0.56, 1.78]

1.3 PTFE v FUSION BIOLINE

1

28

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

1.96 [0.39, 9.83]

2 Primary patency at 12 months Show forest plot

4

305

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

0.96 [0.60, 1.55]

2.1 PTFE v Dacron

1

45

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

0.47 [0.12, 1.79]

2.2 PTFE v PTFE with vein cuff

2

224

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

1.02 [0.59, 1.76]

2.3 PTFE v ringed PTFE

1

36

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

1.48 [0.35, 6.24]

3 Primary patency at 24 months Show forest plot

4

250

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

0.94 [0.56, 1.57]

3.1 PTFE v Dacron

1

40

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

0.41 [0.12, 1.42]

3.2 PTFE v PTFE with vein cuff

2

182

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

1.08 [0.58, 2.01]

3.3 PTFE v ringed PTFE

1

28

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

1.32 [0.31, 5.67]

4 Primary patency at 36 months Show forest plot

1

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

Totals not selected

4.1 PTFE v PTFE with vein cuff

1

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

0.0 [0.0, 0.0]

5 Secondary patency at 3 months Show forest plot

1

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

Totals not selected

5.1 PTFE v HUV

1

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

0.0 [0.0, 0.0]

6 Secondary patency at 6 months Show forest plot

2

242

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

1.21 [0.69, 2.13]

6.1 PTFE v HUV

1

71

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

3.01 [1.12, 8.07]

6.2 PTFE v PTFE with vein cuff

1

171

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

0.79 [0.40, 1.56]

7 Secondary patency at 12 months Show forest plot

3

325

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

1.48 [0.94, 2.34]

7.1 PTFE v HUV

1

101

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

2.46 [1.10, 5.49]

7.2 PTFE v PTFE with vein cuff

2

224

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

1.16 [0.66, 2.03]

8 Secondary patency at 24 months Show forest plot

3

269

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

1.72 [1.05, 2.80]

8.1 PTFE v HUV

1

88

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

3.40 [1.45, 7.97]

8.2 PTFE v PTFE with vein cuff

2

181

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

1.22 [0.67, 2.23]

9 Secondary patency at 36 months Show forest plot

1

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

Totals not selected

9.1 PTFE v PTFE with vein cuff

1

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

0.0 [0.0, 0.0]

10 Limb salvage at 12 months Show forest plot

2

225

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

1.35 [0.72, 2.55]

10.1 PTFE v PTFE with vein cuff

2

225

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

1.35 [0.72, 2.55]

11 Limb salvage at 24 months Show forest plot

2

196

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

1.34 [0.72, 2.49]

11.1 PTFE v PTFE with vein cuff

2

196

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

1.34 [0.72, 2.49]

Figures and Tables -
Comparison 6. Below‐knee PTFE versus all other graft materials
Comparison 7. Below‐knee heparin bonded Dacron versus all other graft materials

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Primary patency at 3 months Show forest plot

1

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

Totals not selected

1.1 HBD v PTFE

1

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

0.0 [0.0, 0.0]

2 Primary patency at 6 months Show forest plot

1

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

Totals not selected

2.1 HBD v PTFE

1

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

0.0 [0.0, 0.0]

3 Primary patency at 12 months Show forest plot

1

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

Totals not selected

3.1 HBD v PTFE

1

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

0.0 [0.0, 0.0]

4 Primary patency at 24 months Show forest plot

1

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

Totals not selected

4.1 HBD v PTFE

1

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

0.0 [0.0, 0.0]

5 Primary patency at 60 months Show forest plot

1

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

Totals not selected

5.1 HBD v PTFE

1

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

0.0 [0.0, 0.0]

Figures and Tables -
Comparison 7. Below‐knee heparin bonded Dacron versus all other graft materials