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Hybrid Procedures for Lower Limb Revascularization (pp.237-250) $100.00
Authors:  (George A. Antoniou, Vassilios Saleptsis, Nikolaos Roussas, Antonios Vouzas, Athanasios D. Giannoukas, Department of Vascular Surgery, University Hospital of Larissa, Faculty of Medicine, University of Thessalia, Larissa, Greece)
Abstract:
Peripheral atherosclerotic arterial disease is commonly associated with a multilevel pattern of occlusive disease, especially in patients with critical limb ischaemia. Optimum results may be achieved with both inflow and outflow arterial reconstruction.
Treatment strategies for multisegment disease include either extensive operative procedures or a combination of endovascular techniques and open vascular surgery, performed in a single or multiple settings.
The incorporation of imaging and endovascular inventory into the standard operative armamentarium and the ever increasing levels of vascular surgeonsí expertise in endoluminal techniques have broadened the scope of management of peripheral arterial disease, allowing less invasive therapeutic options tailored to the needs of these high risk surgical patients.
Simultaneous hybrid endovascular and open lower extremity arterial reconstructive procedures have the advantages of obviating the need for major surgery and avoiding separate staged interventions and their associated morbidity. They may, therefore, expand the potentials of both approaches for the management of the critically or acutely ischaemic limb. There are published results of several types of combined treatment of various patterns of iliac, femoral and infrapopliteal disease with promising outcomes.
Hybrid open and endovascular procedures performed at a single setting provide an effective treatment of multilevel lower extremity atherosclerotic arterial disease. There is data to 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. More extensive disease and interventions, diabetes and dislipidaemia may be associated with worse outcome. Therefore, hybrid procedures for the treatment of severe lower extremity arterial disease provide less invasive therapeutic options tailored to the needs of high risk patients. 


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Hybrid Procedures for Lower Limb Revascularization (pp.237-250)