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Should patients with infrainguinal arterial bypasses using autologous vein conduit undergo follow-up surveillance with duplex ultrasound?

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Show simple item record Healy, D.A. Keogh, C. Bashar, Khalid Sahebally, Shaheel M. Clarke-Moloney, Mary Walsh, Stewart R. 2018-11-26T11:40:23Z 2018-11-26T11:40:23Z 2015
dc.description peer-reviewed en_US
dc.description.abstract This best evidence topic was investigated according to a structured format. The question asked was: should duplex ultrasound (DUS) scanning be a routine component of surveillance following infrainguinal arterial bypass using vein conduit? We performed a systematic literature search and identified 4 studies (3 randomised controlled trials and 1 meta-analysis) that provided the best evidence.The highest quality study was a multi-centre randomised controlled trial (n = 594). At 18 months following surgery, it found no difference in patency rates, amputations, vascular mortality or mortality. However it achieved just over half of anticipated recruitment and thus was underpowered. The remaining two randomised controlled trials had smaller sample sizes and methodological weaknesses and found conflicting results. Lundell et al. (n = 106) found improved primary assisted and secondary patency rates and fewer graft occlusions with a routine DUS policy. Ihlberg et al. (n = 152) found no difference in primary assisted patency or amputations although secondary patency was improved. A meta-analysis of mostly observational data (n = 6649) found fewer occlusions with routine DUS surveillance and no effect on amputations or mortality.Results are conflicting. The strongest evidence comes from the single high quality multi-centre trial. It appears as though routine DUS surveillance does not yield benefits in patient important outcomes. Further studies are needed. (C) 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved. en_US
dc.language.iso eng en_US
dc.publisher Elsevier en_US
dc.relation.ispartofseries International Journal of Surgery;13, pp. 38-41
dc.subject Peripheral vascular disease en_US
dc.subject Bypass en_US
dc.subject Infrainguinal bypass en_US
dc.subject Duplex ultrasound en_US
dc.subject Vein graft en_US
dc.title Should patients with infrainguinal arterial bypasses using autologous vein conduit undergo follow-up surveillance with duplex ultrasound? en_US
dc.type info:eu-repo/semantics/article en_US
dc.type.supercollection all_ul_research en_US
dc.type.supercollection ul_published_reviewed en_US 2018-11-26T11:36:33Z
dc.description.version PUBLISHED
dc.identifier.doi 10.1016/j.ijsu.2014.11.024
dc.rights.accessrights info:eu-repo/semantics/openAccess en_US
dc.internal.rssid 1581546
dc.internal.copyrightchecked Yes
dc.identifier.journaltitle International journal of surgery (London, England)
dc.description.status peer-reviewed

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