Dacron vs. PTFE as bypass materials in peripheral vascular surgery--systematic review and meta-analysis.
BACKGROUND
In peripheral vascular bypass surgery different synthetic materials are available for bypass grafting. It is unclear which of the two commonly used materials, polytetrafluoroethylene (PTFE) or polyester (Dacron(R)) grafts, is to be preferred. Thus, the aim of this meta-analysis and systematic review was to compare the effectiveness of these two prosthetic bypass materials (Dacron and PTFE).


METHODS
We performed a systematic literature search in MEDLINE, Cochrane-Library - CENTRAL, EMBASE and other databases for relevant publications in English and German published between 1999 and 2008. Only randomized controlled trials were considered for inclusion. We assessed the methodological quality by means of standardized checklists. Primary patency was used as the main endpoint. Random-effect meta-analysis as well as pooling data in life table format was performed to combine study results.


RESULTS
Nine randomized controlled trials (RCT) were included. Two trials showed statistically significant differences in primary patency, one favouring Dacron and one favouring PTFE grafts, while 7 trials did not show statistically significant differences between the two materials. Meta-analysis on the comparison of PTFE vs. Dacron grafts yielded no differences with regard to primary patency rates (hazard ratio 1.04 (95% confidence interval [0.85;1.28]), no significant heterogeneity (p = 0.32, I2 = 14%)). Similarly, there were no significant differences with regard to secondary patency rates.


CONCLUSIONS
Systematic evaluation and meta-analysis of randomized controlled trials comparing Dacron and PTFE as bypass materials for peripheral vascular surgery showed no evidence of an advantage of one synthetic material over the other.
Roll
Stephanie
S
Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany. stephanie.roll@charite.de
Müller-Nordhorn
Jacqueline
J
Keil
Thomas
T
Scholz
Hans
H
Eidt
Daniela
D
Greiner
Wolfgang
W
Willich
Stefan N
SN
D001672:Biocompatible Materials / Q000737:chemistry; D001807:Blood Vessel Prosthesis; D006801:Humans; D016491:Peripheral Vascular Diseases / Q000601:surgery; D011093:Polyethylene Terephthalates / Q000737:chemistry; D011138:Polytetrafluoroethylene / Q000737:chemistry; D016032:Randomized Controlled Trials as Topic; D014654:Vascular Patency / Q000502:physiology
D001672:Biocompatible Materials; D011093:Polyethylene Terephthalates; D011138:Polytetrafluoroethylene