Hybrid interventions on aorto-iliac segment and arteries of lower limbs

Department of Vascular Surgery, Department of Endovascular Surgery, Mariinsky Hospital, Saint Petersburg, Russia, Al XIII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” și al III-lea Congres al Societății de Endoscopie, Chirurgie miniminvazivă și Ultrasonografie ”V.M.Guțu” din Republica MoldovaIntroduction: Current progress in endovascular methods and techniques makes possible its effective combination with open surgical procedures. Material and methods: The following hybrid procedures were performed in our department: 34 interventions on aorto-iliac segment (iliac arteries stenting combined with reconstruction of deep femoral artery – 16 cases, loop-endarterectomy from external iliac artery combined with iliac arteries stenting – 18 cases); 25 interventions on femoral-popliteal segment (loop-endarterectomy from superficial femoral artery – 15 cases, iliac stenting combined with loop-endarterectomy from superficial femoral artery – 7 cases, above-knee femoral-popliteal bypass combined with popliteal artery stenting – 3 cases); and 21 interventions on popliteal-tibial segment (loopendarterectomy from popliteal artery with angioplasty of tibial arteries – 8 cases, femoral-peroneal bypass combined with angioplasty of tibial arteries – 13 cases). Completion angiography was routinely performed in all patients for quality control of revascularization. Chronic ischemia grade II Fontaine was diagnosed preoperatively in 19 (23,75%) patients, grade III - in 40 (50%) and grade IV – in 21 (26,25%) patients. Results: Complete regression of ischemic pain, initial signs of healing of superficial defects of soft tissues as well as primary healing of wounds after debridement of necrotic lesions were observed in the postoperative period. Mean duration of hospital stay was 7 days. Conclusion: Thus, implementation of hybrid procedures contributes to the reduction of the volume of open vascular reconstructions. Hybrid interventions represent the optimal approach for treatment of occlusive lesions of aorto-iliac segment and arteries of lower limbs