Bypass surgery for chronic lower limb ischaemia
Clinical bottom line
Despite being widely used, there is little evidence for the effectiveness of bypass surgery from randomised trials.
Reference
GC Leng et al. Bypass surgery for chronic lower limb ischaemia. Cochrane Database of Systematic Reviews 2000 issue 3.
Background
Occluded arterial segments in patients with limb ischaemia are frequently removed surgically, using bypass techniques. The surgery is commonly used, but was introduced without formal evaluation.
Systematic review
- Date review completed: April 2000
- Number of trials included: 6
- Number of patients: 700
- Control group: angioplasty, exercise, spinal cord stimulation
- Main outcomes: mortality, operative failure
Results
There were no clear differences between bypass surgery and percutaneous angioplasty. Amputation rates were lower with bypass surgery than thrombolysis. This is all based on very small numbers of patients.
Comment
Despite being widely used there is limited evidence to support bypass surgery.