Meta-analysis of femoropopliteal bypass grafts for lower extremity arterial insufficiency

Pereira, Carlos Eduardo; Albers, Maximiano; Romiti, Marcello; Brochado-Neto, Francisco Cardoso; Pereira, Carlos Alberto Braganaa

doi:10.1016/j.jvs.2006.04.054

Cited by 226 publications

(139 citation statements)

References 63 publications

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“…For each study, the HR with corresponding 95% confidence intervals (CI) was directly extracted from the research article or estimated using Kaplan-Meier survival curves (18 (20,21). Statistical significance (P<0.05) was assessed for the cumulative survival rate differences between ATT group and no-ATT group at yearly intervals.…”

Section: Statistical Analysesmentioning

confidence: 99%

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Should aggressive thoracic therapy be performed in patients with synchronous oligometastatic non-small cell lung cancer? A meta-analysis

Li¹,

Zhu²,

Wang³

et al. 2017

J. Thorac. Dis.

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Background: We performed a meta-analysis to compare overall survival (OS) outcomes in patients with synchronous oligometastatic non-small cell lung cancer (NSCLC) who underwent aggressive thoracic therapy (ATT) with those who did not. Methods: A systematic review of controlled trials of ATT on survival in synchronous oligometastatic NSCLC was conducted. Hazard ratio (HR) for the main endpoint OS was pooled using a fixed-effects model. Subgroup analysis was performed in patients with single organ metastases, or with different numbers of brain metastases, or with different stages of thoracic disease. Pooled survival curves of OS were constructed. Results: Seven eligible retrospective observational cohort studies were identified including 668 synchronous oligometastatic NSCLC patients, of whom 227 (34.0%) received ATT. For patients with synchronous oligometastatic NSCLC, ATT was associated with a significant improvement of OS (HR, 0.48; 95% CI, 0.39-0.60; P<0.00001). In subgroup analysis, the association with OS was similar or even strengthened, with a HR of 0.42 (95% CI, 0.31-0.56) in single organ metastases group, 0.49 (95% CI, 0.31-0.75) in solitary brain metastasis group, and 0.38 (95% CI, 0.20-0.73) in thoracic stage I-II group, respectively. The pooled cumulative survival rates for patients received ATT were 74.9% at 1 year, 52.1% at 2 years, 23.0% at 3 years, and 12.6% at 4 years. The corresponding pooled survival for patients who did not receive ATT were 32.3%, 13.7%, 3.7%, and 2.0%, respectively. Conclusions: Survival benefit from ATT is common in synchronous oligometastatic patients. Selected patients with synchronous oligometastatic NSCLC could also achieve long-term survival with ATT. Targeted therapy have shown efficacy in the treatment of advanced NSCLC, however, most patients progress after a median survival of 12 months because of resistance (4-6).Hellman and Weichselbaum proposed the existence of a clinically recognisable state termed 'oligometastases', which is an intermediate state of metastases characterized by a limited number and site of metastatic tumors. In these selected patients, eradication of oligometastases could be curative (7,8). However, whether the aggressive thoracic therapy (ATT) could potentially improve overall survival (OS) in oligometastatic NSCLC remains unclear. Removal of the primary tumor was shown to improve OS in patients with metastatic renal cancer (9), by contrast, locoregional treatment of the primary tumor did not affect OS in patients with metastatic breast cancer (10). More and more studies reported favorable long-term survivals in oligometastatic NSCLC treated with aggressive local therapy (11-13). However, these studies are retrospective and the validity of the survival benefit are challenging due to patient selection.Recently, Ashworth et al. did a systematic review of literature considering NSCLC patients with 1-5 metastases treated with local therapy and found that definitive treatment of the primary tumor was a good prognostic factor for survival (14). Moreo...

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Section: Statistical Analysesmentioning

confidence: 99%

“…The pooled survival curves also suggested an OS benefit from ATT over no-ATT in patients with synchronous oligometastatic NSCLC. Limitations of this method were still existed, such as omitted losses to follow-up, a flat tail in the survival curve (20) and so on.…”

Section: Subgroup Analysesmentioning

confidence: 99%

Should aggressive thoracic therapy be performed in patients with synchronous oligometastatic non-small cell lung cancer? A meta-analysis

Li¹,

Zhu²,

Wang³

et al. 2017

J. Thorac. Dis.

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“…Only a very small percentage of patients with intermittent claudication require the saphenous vein for coronary bypass 6 . Femoropopliteal bypass with autologous vein has had the best revascularization results for decades and a metaanalysis of studies, performed by Pereira, confirms this fact 7 . Primary patency when using the saphena vein after five years ranges between 75-84% (ref.…”

Section: Surgical Treatmentmentioning

confidence: 83%

“…Primary patency when using the saphena vein after five years ranges between 75-84% (ref. [6][7][8][9] ). Eugster evaluated the results of only patients with intermittent claudication and presented an excellent primary patency after 10 years of 63.5% and primary assisted patency up to 87.3% (ref.…”

Section: Surgical Treatmentmentioning

confidence: 99%

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Current treatment methods for long occlusions of the femoropopliteal segment in patients with intermittent claudication: Minireview

Fialová¹,

Utíkal²,

Bachleda³

et al. 2015

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Backround. Intermittent claudication is a classic symptom of peripheral arterial disease. It is mainly treated conservatively but if this fails, a form of revascularization is indicated. The revascularization in chronic occlusion of femoropopliteal region is currently performed by two basic methods: the standard method of surgical bypass and the newer miniinvasive alternative represented by the endovascular method. The treatment of patients with solely claudication and long occlusion of femoropopliteal region remains controversial. The aim of this minireview was to determine whether surgical bypass is still the best method of choice in a time of endovascular techniques. Methods. A MEDLINE search for original and review articles using key terms, intermittent claudication and long femoropopliteal oclusion. Results and Conclusion. No ideal treatment for long occlusions of the femoropopliteal segment has been established to date. It is clear that the role of endovascular techniques in the treatment of SFA occlusions is increasing. It remains that, lower risk patients with claudication should be examined to assess the quality of veins suitable for revascularization and bypass should be selected as the first method of choice.

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Graft type for femoro-popliteal bypass surgery

Twine

McLain

2010

Cochrane Database of Systematic Reviews

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Analysis 2.1. Comparison 2 Above-knee PTFE versus all other graft materials, Outcome 1 Primary patency at 3 months. Analysis 2.2. Comparison 2 Above-knee PTFE versus all other graft materials, Outcome 2 Primary patency at 6 months. Analysis 2.3. Comparison 2 Above-knee PTFE versus all other graft materials, Outcome 3 Primary patency at 12 months. Analysis 2.4. Comparison 2 Above-knee PTFE versus all other graft materials, Outcome 4 Primary patency at 24 months. Analysis 2.5. Comparison 2 Above-knee PTFE versus all other graft materials, Outcome 5 Primary patency at 60 months.

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Meta-analysis of femoropopliteal bypass grafts for lower extremity arterial insufficiency

Abstract: The great saphenous vein performs better than polytetrafluoroethylene in femoropopliteal bypass grafting and should be used whenever possible.

Cited by 226 publications

References 63 publications

Should aggressive thoracic therapy be performed in patients with synchronous oligometastatic non-small cell lung cancer? A meta-analysis

Should aggressive thoracic therapy be performed in patients with synchronous oligometastatic non-small cell lung cancer? A meta-analysis

Current treatment methods for long occlusions of the femoropopliteal segment in patients with intermittent claudication: Minireview

Graft type for femoro-popliteal bypass surgery

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