Combined Direct Repair and Inline Inflow Stenting in the Management of Aortoiliac Disease Extending Into the Common Femoral Artery

Sharafuddin, Melhem J.; Kresowik, Timothy F.; Hoballah, Jamal J.; Nicholson, Rachael; Sharp, William J.

doi:10.1177/1538574410395037

Cited by 8 publications

(11 citation statements)

References 43 publications

(53 reference statements)

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“…8,[17][18][19][20][21] Most case series are relatively small and just report on periprocedural complications and long-term outcomes regarding patency and limb salvage. 17,[22][23][24] Some compare hybrid procedures on the basis of indications such as claudication, CLI, and acute limb ischemia or the direction of the endovascular intervention (inflow vs outflow). 13,18,19 Dosluoglu et al 20 compared hybrid revascularization with open and endovascular therapy.…”

Section: Discussionmentioning

confidence: 99%

Hybrid femoropopliteal procedures are associated with improved perioperative outcomes compared with bypass

Jorshery

Skrip²,

Sarac

et al. 2018

Journal of Vascular Surgery

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Objective: Hybrid procedures have gained momentum as less invasive operations that can potentially improve outcomes for patients. However, there is a paucity of data comparing hybrid procedures with traditional bypass. This study compares the perioperative outcomes of hybrid and bypass surgery for femoropopliteal (FP) revascularization. Methods: The American College of Surgeons National Surgical Quality Improvement Program files (2012-2015) were reviewed, and three groups of patients undergoing isolated FP revascularization were identified by Current Procedural Terminology codes. All patients underwent femoral endarterectomy. The hybrid group (HYB) had a concomitant antegrade endovascular FP intervention and was compared with patients with concomitant FP bypass with vein (BPV) and FP bypass with nonvein graft (BPG). The demographics, comorbidities, and outcomes of the three groups were analyzed. The c 2 and analysis of variance tests with post hoc analysis were used. A multivariable logistic regression analysis was performed to identify predictors of readmission, reoperation, and mortality. Results: There were 1480 patients in the analysis. Compared with patients undergoing BPV and BPG, patients in the HYB group tended to be older (P ¼ .016) and were less likely to be smokers (P < .001). They had fewer infected wounds (P ¼ .001) and were more likely to have American Society of Anesthesiologists score #3 (P ¼ .01) and claudication (P < .01). HYB patients had significantly fewer bleeding transfusions (P ¼ .01) and less overall morbidity (P < .001) compared with BPV and BPG patients. The three treatment groups did not differ in frequencies of mortality and major amputation. Among the groups, BPV was associated with the longest operating time (P < .001), whereas HYB had significantly shorter hospital stay (P < .001). HYB was also associated with significantly lower rates of reoperation (P ¼ .017) and readmission (P ¼ .007). On multivariable regression, patients undergoing BPG were at increased risk of readmission (odds ratio [OR], 1.48 [1.00-2.17]) compared with HYB. HYB surgery was associated with less morbidity compared with BPV (OR, 1.38 [1-1.9]) and BPG (OR, 1.77 [1.3-2.38]). Conclusions: Hybrid procedures have favorable perioperative outcomes compared with open bypass for FP revascularization. Additional research on the long-term outcomes of hybrid procedures is needed.

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Section: Discussionmentioning

confidence: 99%

Hybrid femoropopliteal procedures are associated with improved perioperative outcomes compared with bypass

Jorshery

Skrip²,

Sarac

et al. 2018

Journal of Vascular Surgery

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“…Initial database query provided 1694 reports (Figure 1), and of these 29 were judged relevant based on abstract review. 12–40 Twenty of these reports were included after final review by the authors. 12–16,18,19,21,22,25–28,31,33,35–37,39,40 After reviewing the full paper, data regarding patient numbers and demographics, indications, pre- and post-intervention ankle-brachial index (ABI), site of intervention, and patency of SFA, technical success, type of endovascular approach, complications, patency and mortality rates were extracted and analyzed (Table 1).…”

Section: Methodsmentioning

confidence: 99%

A pooled analysis of common femoral and profunda femoris endovascular interventions

Bath

Avgerinos

2016

Vascular

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“…Although we currently do not hesitate to extent the stents into the common femoral artery segment to cover any limiting underlying disease, we have also increasingly adopted hybrid strategies combining direct common femoral artery (CFA) repair with inline iliac stenting extending into the endarterectomized segment on an interposition graft, with excellent shortand intermediate-term outcomes. 50 We noted a nonsignificant trend toward lower delayed patency following sharp recanalization and wire-end techniques was appreciated on life-table analysis (Figure 3). This, however, likely reflects the complex associated anatomy of these lesions, and the small number of patients in the study.…”

Section: Discussionmentioning

confidence: 86%

Impact of Aggressive Endovascular Recanalization Techniques on Success Rate in Chronic Total Arterial Occlusions (CTOs)

Sharafuddin

Hoballah

Kresowik

et al. 2010

Vasc Endovascular Surg

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Combined Direct Repair and Inline Inflow Stenting in the Management of Aortoiliac Disease Extending Into the Common Femoral Artery

Abstract: Inline stenting represents a lesser invasive revascularization choice in complex AIOD with contiguous involvement of the CFA.

Cited by 8 publications

References 43 publications

Hybrid femoropopliteal procedures are associated with improved perioperative outcomes compared with bypass

Hybrid femoropopliteal procedures are associated with improved perioperative outcomes compared with bypass

A pooled analysis of common femoral and profunda femoris endovascular interventions

Impact of Aggressive Endovascular Recanalization Techniques on Success Rate in Chronic Total Arterial Occlusions (CTOs)

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