Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2000 May;49(5):479-83.
doi: 10.1046/j.1365-2125.2000.00178.x.

Graft material and results of platelet inhibitor trials in peripheral arterial reconstructions: reappraisal of results from a meta-analysis

H R Watson  1 , A M Skene, G Belcher
Affiliations

Graft material and results of platelet inhibitor trials in peripheral arterial reconstructions: reappraisal of results from a meta-analysis

H R Watson et al. Br J Clin Pharmacol. 2000 May.

Abstract

Aims: To investigate the characteristics of published trials in order to establish the origin of the differing results obtained in trials of platelet inhibitors after peripheral bypass procedures.

Methods: Analysis of the information from 11 randomised, controlled trials of platelet inhibitors after peripheral bypass procedures published up until 1999 and involving 2302 patients undergoing peripheral bypass operations, 1250 of whom were treated with platelet inhibitors.

Results: There is a significant treatment benefit of platelet inhibitors on meta-analysis of the trials, but a significant heterogeneity amongst the individual trial results. The proportion of patients in a trial with prosthetic grafts was a significant factor in explaining the heterogeneity. Proportion of prosthetic grafts was associated with sample size and with the proportion of grafts above the knee, but these were not found to make an independent contribution to the heterogeneity observed. The platelet inhibitor regimen used, the severity of ischaemic symptoms and the proportion of smokers included were also not found to be important.

Conclusions: The improvement of graft patency by aspirin and related platelet inhibitors in clinical trials in peripheral bypass procedures can be attributed to an effect on patients with prosthetic grafts. There is little evidence that these agents prevent occlusion of vein grafts. The conclusion of an earlier meta-analysis that antiplatelet agents should be used for all bypasses is not supported.

PubMed Disclaimer

Figures

Figure 2
Figure 2
Association of sample size and the difference in patency rates.
Figure 1
Figure 1
Association between the percentage of patients with prosthetic grafts and the difference in patency rates. Differences are plotted with standard errors. • trials with one active group, ○ trials with two active groups.
Figure 3
Figure 3
Association between the percentage of patients with above-knee grafts and the difference in patency rates. Differences are plotted with standard errors. • trials with one active group, ○ trials with two active groups.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Rutherford RB, Jones DN, Bergentz S-E, et al. Factors affecting the patency of infrainguinal bypass. J Vasc Surg. 1988;8:236–246. - PubMed
    1. Antiplatelet Trialists’ Collaboration. Collaborative overview of randomised trials of antiplatelet therapy – II. Maintenance of vascular graft or arterial patency by antiplatelet therapy. Br Med J. 1994;308:159–168. - PMC - PubMed
    1. Zekert F. Klinische Anwendung von Aggregationshemmern bei arterieller Verschlusskrankheit. In: Zekert F, editor. Thrombosen, Embolien und Aggregationshemmer in der Chirurgie. Stuttgart: Schattauer; 1975. pp. 68–72.
    1. Ehresmann U, Alemany J, Loew D. Prophylaxe von Rezidivverschlüssen nach Revaskularisationseingriffen mit Acetylssalicylsäure. Med Welt. 1977;28:1157–1162. - PubMed
    1. Harjola P-T, Meurala H, Frick HH. Prevention of early reocclusion by dipyridamole and ASA in arterial reconstructive surgery. J Cardiovasc Surg (Torino) 1981;22:141–144. - PubMed

MeSH terms

Substances