Staged Hybrid Revascularization in Patients with Peripheral Arterial Occlusive Disease

Sin, Min Ho; Chang, Jeong Hwan

Abstract

PURPOSE
With the development of endovascular interventions, hybrid reconstructions, which include the combination endovascular procedure and open bypass surgery, have been increasingly used for the management of peripheral arterial occlusive disease (PAOD). The goal of this study is to present our results in the management of PAOD and to define the role of staged hybrid techniques in patients who need revascularization compared to other revascularization procedures, such as open or endovascular techniques.
METHODS
We reviewed 104 patients who underwent arterial revascularization between January 2005 and June 2010, retrospectively. The data were divided into three groups by treatment modality: the open bypass group (n=47, 45.2%), the endovascular group (n=46, 44.2%), and the staged hybrid group (n=11, 10.6%), and were classified according to the Trans-Atlantic Society Consensus II (TASC II) A/B/C/D. Patients' characteristics, overall primary and secondary patency rates, and 30-day complications were compared between the three groups.
RESULTS
Mean age was 69.6 years and 84.6% were male. There were more TASC II D lesions and multiple lesions in the hybrid group. There were no statistically significant differences in the 36-month mortality rate, primary patency rate, and secondary patency rate among the three groups (P=0.170, 0.838, and 0.767, respectively).
CONCLUSION
Staged hybrid revascularization is an acceptable strategy in patients with PAOD, especially TASC II D and multiple lesions for suitable case with comparable patency, even though the number of cases was relatively small.