A contemporary meta-analysis of Dacron versus polytetrafluoroethylene grafts for femoropopliteal bypass grafting.
BACKGROUND
The present study provides a contemporary and comprehensive summation of midterm patency rates of polyester (Dacron) or polytetrafluoroethylene (PTFE) grafts in femoropopliteal bypass grafting based on a meta-analysis consisting only of randomized controlled trials.


METHODS
MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched to identify all randomized controlled trials of Dacron vs PTFE grafts in femoropopliteal bypass grafting. Seven trials were found. Survival data were combined to yield the pooled cumulative primary patency. We estimated the log hazard ratio (HR) for each 1-month interval and then combined the HRs in a stratified way across intervals to obtain an overall log HR for each trial. Study-specific estimates were combined using inverse variance-weighted averages of logarithmic HRs in fixed-effects and random-effects models.


RESULTS
The pooled cumulative primary patency of Dacron and PTFE grafts was, respectively, 60.2% (95% confidence interval [CI], 56.4%-64.0%) and 53.8% (95% CI, 46.8%-60.9%) at 3 years, and 49.2% (95% CI, 45.6%-52.7%) and 38.4% (95% CI, 32.2%-44.6%) at 5 years. Pooled analysis of the seven trials demonstrated no difference in HR for graft occlusion with Dacron relative to PTFE grafts (random-effects HR, 0.87; 95% CI, 0.67-1.12; P = .27 for effect; P = .03 for heterogeneity).


CONCLUSIONS
Either Dacron or PTFE grafts can be used in femoropopliteal bypass grafting with no significant differences in midterm graft patency at 5 years (49.2% vs 38.4%) when the autologous saphenous vein is unavailable.
Takagi
Hisato
H
Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan. kfgth973@ybb.ne.jp
Goto
Shin-Nosuke
SN
Matsui
Masafumi
M
Manabe
Hideaki
H
Umemoto
Takuya
T
D001157:Arterial Occlusive Diseases / Q000503:physiopathology / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D019317:Evidence-Based Medicine; D005263:Femoral Artery / Q000503:physiopathology / Q000601:surgery*; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D011093:Polyethylene Terephthalates; D011138:Polytetrafluoroethylene; D011150:Popliteal Artery / Q000503:physiopathology / Q000601:surgery*; D011474:Prosthesis Design; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency
D011093:Polyethylene Terephthalates; D011138:Polytetrafluoroethylene