for the main comparison.
| Bypass surgery compared with angioplasty for chronic lower limb ischaemia | ||||||
|
Patient or population: Individuals with peripheral arterial disease Settings: Hospital Intervention: Bypass surgery Comparison: Percutaneous transluminal angioplasty | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Angioplasty | Bypass surgery | |||||
|
Early postoperative non‐thrombotic complications Follow up: 30 days |
Medium risk population1 | OR 1.29 (0.96 to 1.73) | 1015 (6 studies) | ⊕⊕⊕⊕ high | ||
| 245 per 1000 | 295 per 1000 (238 to 360) | |||||
|
Procedural mortality Follow up: 30 days |
Medium risk population1 | OR 1.67 (0.66 to 4.19) | 913 (5 studies) | ⊕⊕⊕⊕ high | Three studies reported no cases of procedural mortality | |
| 15 per 1000 | 25 per 1000 (10 to 60) | |||||
|
Clinical improvement Follow up: 23‐48 months |
Medium risk population1 | OR 0.65 (0.03 to 14.52) | 154 (2 studies) | ⊕⊕⊝⊝ low2, 3 | Estimate effect based on two studies | |
| 800 per 1000 | 722 per 1000 (107 to 983) | |||||
|
Amputation Follow up: 12‐48 months |
Medium risk population1 | OR 1.24 (0.82 to 1.87) | 752 (5 studies) | ⊕⊕⊕⊕ high | ||
| 126 per 1000 | 152 per 1000 (106 to 213) | |||||
|
Primary patency Follow up: 12 months |
Medium risk population1 | OR 1.94 (1.20 to 3.14) | 300 (4 studies) | ⊕⊕⊕⊝ moderate3 | ||
| 583 per 1000 | 731 per 1000 (627 to 814) | |||||
|
Primary patency Follow up: 4 years |
Medium risk population1 | OR 1.15 (0.74 to 1.78) | 363 (2 studies) | ⊕⊕⊕⊕ high | Estimate effect based on two studies | |
| 633 per 1000 | 665 per 1000 (561 to 755) | |||||
|
Mortality within follow‐up Follow up: 12‐48 months |
Medium risk population1 | OR 0.94 (0.71 to 1.25) | 961 (5 studies) | ⊕⊕⊕⊕ high | ||
| 371 per 1000 | 357 per 1000 (295 to 424) | |||||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; OR: Odds Ratio | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1 Based on studies including both claudication and critical ischaemia participants; the assumed risk was calculated by the mean number of events in the control groups of the selected studies for each outcome. 2 Subjective outcome assessment and no blinding. 3 Heterogeneity in treatment effect among studies.