Hybrid Procedure in Limb Salvage

  • #HS 01-O-8
  • Hybrid Surgery. SESSION-1
  • Oral

Hybrid Procedure in Limb Salvage

Simon Papoyan 1, Alexandr Schegolev 2, Alexandr Mitichkin 1, Maxim Sazonov 1, Alexey Krasnikov 1, Marat Mutaev 1, Alexandr Krasnikov 1, Daniil Siromyatnikov 1

Inozemtcev Moscow Municipal Hospital, Moscow, Russia; Pirogov National Research Medical University, Moscow, Russia;

Date, time and location: 2018.05.26 13:30, Congress Hall, 2F–A


Objective: To improve the surgical treatment of patients with multilevel lesions of arteries of lower extremities.

Material and Methods: From March 2013 to June 2017 58 patients with multilevel lower extremity arterial occlusive disease underwent hybrid procedure . The mean age was 66 years (range: 39-82) Most patients were male (31 males, 55%). According to the Fontaine grading, 26 patients (43%) were treated for severe intermittent claudication , 25 patients (39%) had persistent rest pain and 97 patients (24%) had minor tissue loss . And 1 patient with acute ischemia. Iliac lesions were defined according to the TASC II Type A 5 patients type B 3 patients type D 12 patientsThe most commonly associated cardiovascular risk factors were hypertension (100%), smoking (59%), dyslipidaemia (73.6%), coronary artery disease (76.3%). Totally 60 hybrid interventions were performed (2 patients underwent procedures on both extremities).

Techniquе: The most common open procedure was endarterectomy of the External iliac artery and stenting  41  , SFA remote endarterectomy folowed by PTA of BTK vessels 12 cases, Iliac stenting with SFA endarterectomy in 9 cases Iliac stenting Femoro-popliteal bypass 8.


Technical success was achieved in all patients (100%). Mean ABPI increase was 0.40. Mean length of hospital stay (6.1 days). The median follow-up period was 10.5 months (range, 1-18 months); Primary patency rates at 12 months 86.7%. Limb salvage rates 95%.

Conclusions: Hybrid procedures provide an effective treatment of multilevel lower extremity in critical limm ischemia . Our data suggest that the immediate results, expressed as technical and haemodynamic success and the mid-term outcomes, represented by the patency and limb-salvage rates, are satisfactory.

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