[Meta analysis of clinical safety and efficacy evaluation of peripheral arterial disease patients with critical limb ischemia who accepted bypass surgery or endovascular therapy].

Objective: To evaluate the safety and efficacy of peripheral arterial disease patients with critical limb ischemia who accepted BSX or EVT. Methods: According to the requirements of systematic review, we searched MEDLINE (1980-2014), Emabse (1980-2014), Journals @ Ovid Full Text (1980-2014) databases, selected literature and extracted data, meta-analysis was performed through STATA11.2. Results: A total of 17 studies (3 RCTs, 14 non-randomized studies) and 5 515 patients (BSX group: 2 454, EVT group: 2 769) were deemed eligible. Meta-analysis showed there were no differences between the two groups in 30-day mortality (OR=1.110, P=0.523). However, BSX was significantly associated with increasing overall complications (OR=2.456, P=0.003), infections (OR=3.163, P<0.001) and thrombosis (OR=3.069, P=0.002), but showed a reduction in dissection and pseudoaneurysm (OR=0.537, P=0.012). During the follow-up, BSX had significant advantages. The 1-year and 3-year primary patency of BSX patients were higher than EVT group (1 year, OR=1.415, P=0.008; 3 years, OR=1.619, P<0.001); so were in secondary patency( 1 year, OR=2.156, P<0.001; 3 years, OR=2.547, P<0.001). Meanwhile, the 5-year overall survival rate was also higher in BSX group (OR=1.243, P=0.007). Conclusions: EVT has potential advantages in reducing surgical trauma and early postoperative complications, shortening hospital stay and so on. Concerning long-term results, BSX is better in reducing long-term mortality and improving long-term patencies than EVT group.

[Evaluation between bypass surgery and endovascular therapy to peripheral arterial disease patients with critical limb ischemia].

Bypass surgery(BSX) and endovascular therapy(EVT) are the most important therapeutic method to critical limb ischemia.EVT has potential advantages in reducing surgical trauma and early postoperative complications, shortening hospital stay and so on. Concerning long-term results, BSX is better in reducing long-term mortality and improving long-term patency than EVT group. Therefore, control indications reasonably and select individualized methods, avoid the abuse of EVT are more meaningful for patients.