![]() Other outcomes were not evaluated in these studies. We observed no evidence of a difference between the two surgical techniques for the other evaluated outcomes (lymphocele and lymphorrhea). In this systematic review, we found low‐certainty evidence that performing transverse groin incision to access the femoral artery resulted in fewer surgical wound infections compared with performing vertical groin incision. paresthesia), amputation, graft patency, and postoperative pain. High‐quality studies are needed to enable a comparison of the two surgical techniques with respect to other outcomes, such as infection of the vascular graft (endoprosthesis/prosthesis), prolonged hospitalization, reoperative surgery, death, neurological deficit (e.g. We downgraded the certainty of evidence for lymphatic complications by one level due to serious limitations in the design (there was a high risk of bias in critical domains) and by two further levels because of imprecision (small number of participants and only one study included). ![]() We observed no evidence of a difference between the two surgical techniques for the other evaluated primary outcome 'lymphatic complications': lymphocele (RR 0.46, 95% CI 0.20 to 1.02 1 study 116 groins) and lymphorrhea (RR 2.77, 95% CI 0.92 to 8.34 1 study 116 groins). This is likely due to the small number of studies and participants. The confidence interval for surgical wound infection is relatively wide, further indicating that the certainty of the effect estimate is low. We downgraded the certainty of the evidence for surgical wound infection by one level due to serious limitations in the design (there was a high risk of bias in critical domains). ![]() There was low heterogeneity between the studies. Meta‐analysis of the two studies showed low‐certainty evidence that transverse groin incision resulted in a lower risk of surgical wound infection in the 10‐ to 28‐day period following surgery (risk ratio 0.25, 95% confidence interval 0.08 to 0.76 2 studies 283 groin incisions). Infection of the surgical wound was the only outcome that was similar in both studies, and that could therefore be submitted to a combined analysis. These two studies had a combined total of 237 participants (283 groins). We included one RCT and one qRCT in this review. Two review authors (MVCRC, FCN) independently selected the studies, assessed risk of bias, extracted data, performed data analysis and graded the certainty of evidence according to GRADE. We included randomized controlled trials (RCTs) and quasi‐randomized trials (qRCTs) that compare transverse and vertical groin incision, during either endovascular or open surgery procedures. The review authors searched the IBECS database to 26 March 2020 and reference lists of relevant studies/papers. ![]() ![]() The Cochrane Vascular Information Specialist searched the Cochrane Vascular Specialised Register, CENTRAL, MEDLINE, Embase, CINAHL and AMED databases, and the World Health Organization (WHO) International Clinical Trials Registry Platform and to 17 February 2020. To evaluate the efficacy and safety of transverse groin incision compared with vertical groin incision for accessing the femoral artery in endovascular surgical procedures and open surgery. We will compare the transverse surgical technique-a cut made parallel to the groin crease-versus the vertical groin incision surgical technique-classic technique: a surgical cut made across the groin crease-to access the femoral artery, in an attempt to determine which technique has the lower rate of complications, is safer and is more effective. The surgical technique used to access the femoral artery may be a factor in the occurrence of postoperative complications this will be the focus of our review. bifemoral aortic bypass or infrainguinal bypass), endovascular repair of abdominal aortic aneurysm (EVAR), thoracic endovascular aneurysm repair (TEVAR) and transcatheter aortic valve implantation (TAVI). Access to the femoral vessels is necessary for a wide range of vascular procedures, including treatment of thromboembolic disease, arterial grafts (i.e. ![]()
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