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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
A Journal on Vascular and Endovascular Surgery
Italian Journal of Vascular and Endovascular Surgery 2015 March;22(1):15-9
Hybrid revascularization for iliac-femoral obstructive disease
Piffaretti G. 1, Rivolta N. 1, Bossi M. 1, Fontana F. 2, Piacentino F. 2, Castelli P. 1
1 Unit of Vascular Surgery, Department of Surgery and Morphological Sciences, Varese University Hospital, University of Insubria School of Medicine, Varese, Italy;
2 Unit of Interventional Radiology, Department of Surgery and Morphological Sciences, Varese University Hospital, University of Insubria School of Medicine, Varese, Italy
AIM: The aim of this paper was to report mid-term outcomes of hybrid revascularization for iliac-femoral obstructive disease combining open common femoral endarterectomy and iliac artery stenting.
METHODS: Between January 2004 and March 2012, 44 patients were included into the analysis. It is a single center experience with a retrospective analysis of the data. Preoperatively, all patients underwent echo-color-Doppler and computed tomography angiography (CT-A) to assess aorto-iliac and femoro-popliteal vessels. All the interventions were performed in the operating theatre equipped with a mobile C-arm. Follow-up included clinical visit with Ankle-Brachial Index (ABI) and echo-color-Doppler at 6-month-intervals during the first year, and once per year thereafter.
RESULTS: Operative indication was severe claudication (N.=29, 69.0%), rest pain (N.=12, 27.3%), and tissue loss (N.=3, 6.8%). TASC D lesion was observed in 19 (43.2%) cases, bilateral lesions were 16 (36.4%). Occlusion was present in 22 (50.0%) cases. The technical success rate was 100%. Mean hospitalization was 5.9±2.8 days (range, 2-15). In-hospital mortality occurred in 1 (2.4%) case (stroke N.=1). No early thrombosis was observed. The mean follow-up was 24.2±21.6 months (range, 1-84; median, 12). Primary patency was 89.6% at 1 year, and 82.7% at 3 and 5 years. Major or minor amputations were never required.
CONCLUSION: In our experience, hybrid treatment for iliac-femoral obstructive disease is a safe and viable alternative to conventional open bypasses.