Hybrid Revascularization by Common Femoral Artery Endarterectomy and Proximal or Distal Angioplasty in Patients with Critical Lower Limb Threatening Ischemia

Labeb, Muhammad; Fekry, Meera Refat

doi:10.21608/muj.2023.257948.1157

Hybrid Revascularization by Common Femoral Artery Endarterectomy and Proximal or Distal Angioplasty in Patients with Critical Lower Limb Threatening Ischemia

Document Type : Original Article

Authors

Muhammad Labeb ¹^{, 2}
Meera Refat Fekry ³^{, 4}

¹ Vascular surgery unit, faculty of medicine, port said university

² As-salam hospital - Egypt healthcare authority-Portsaid - Egypt

³ Vascular surgery unit, faculty of medicine, Suez canal university

⁴ Ismailia medical complex - Egypt healthcare authority - Ismailia -Egypt

10.21608/muj.2023.257948.1157

Abstract

Background: Hybrid approach has been considered as an effective technique for reconstruction of multi-level arterial stenosis or occlusion. The simultaneous combined techniques have shown satisfactory outcomes in terms of patency, technical success and less invasiveness in high-risk patients. The purpose of this study to compare CFA endarterectomy (CFE) combined with either proximal or distal endovascular intervention or both.
Methods: retrospective study of prospectively collected data of patients presented with critical limb threatening ischemia (CLTI) with multi-level peripheral arterial disuses include femoral territory and proximal and/or distal arterial disease. All patients had CFE and endovascular intervention at Egypt healthcare authority hospitals.
Results: this study included 30 patients stratified into three groups according to the site of concurrent endovascular intervention; group 1 had proximal endovascular intervention (n=7); group 2 had distal endovascular intervention (n=12); and group 3 with combined proximal and distal intervention (n = 11), 100% technical success reported with overall primary patency at 24 months of 85%. Limb salvage at 24 months was 92.5%.
Conclusion: Common femoral endarterectomy is the gold standard treatment for common femoral artery lesions with excellent patency. In multi-level peripheral arterial disease, the endovascular intervention could improve the outcome and maintain patency and limb salvage.

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