Research article

Dacron^® vs. PTFE as bypass materials in peripheral vascular surgery – systematic review and meta-analysis

Stephanie Roll¹ , Jacqueline Müller-Nordhorn¹ , Thomas Keil¹ , Hans Scholz² , Daniela Eidt³ , Wolfgang Greiner⁴ and Stefan N Willich¹

¹  Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany

²  Department of Vascular Surgery, Queen Elisabeth Hospital, Berlin, Germany

³  Centre for Health Economics and Health System Research, University of Hanover, Germany

⁴  Department of Health Economics and Health Management, University of Bielefeld, Germany

author email corresponding author email

BMC Surgery 2008, 8:22doi:10.1186/1471-2482-8-22

Published:	19 December 2008

Abstract

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^®) 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.

Conclusion

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.