Hybrid external iliac selective endarterectomy surgical technique and outcomes

Abstract

Hybrid-based external iliac and femoral endarterectomy provides a minimally invasive approach to EIA occlusive disease comparable with aortofemoral bypass. Dramatic inflow improvement was observed in our series, and the need for additional outflow revascularization was minimal. The procedure was deemed technically feasible and safe, with a low number of adverse sequela and excellent primary patency achieved more than 1 year after the intervention.

Lower extremity arterial disease in patients with diabetes: a contemporary narrative review

“…The endovascular revascularization may be a good strategy for short (< 5 cm) stenosis or occlusion of iliac arteries, providing a good long-term patency [ 146 ]. Whereas, a hybrid procedure (endarterectomy or bypass at the femoral level combined with endovascular therapy) may be indicated for ilio-femoral lesions [ 147 ]. Aorto-femoral bypass is the first line strategy in aorto-iliac occlusions in patients who fit for surgery [ 148 ], while an endovascular procedure should be considered in long or bilateral lesions in patients with severe comorbidities [ 145 , 149 ].…”

Remote Iliac Artery Endarterectomy: A Case Series and Systematic Review

“…Six studies [7][8][9][10][11]13 (Table 2; Figure 3) were eligible for inclusion, encompassing 419 limbs treated in 407 patients; adding to this the current series produced 532 limbs for analysis. All studies were nonrandomized and retrospective except one.…”

“…Queral et al 8 employed an angioplasty balloon before advancing the ring stripper to create the dissection plane. Kavanagh et al 13 used a balloon inside the ring stripper to dissect the intimal core rather than the MollRing Cutter. All but Smeets et al 10 passed the lesion with a guidewire before advancing the ring stripper.…”

“…Smeets et al 10 defined patency as absence of occlusion or >70% restenosis. Kavanagh et al 13 and Topel et al 11 did not provide a definition. Patency rates ranged from 75% to 100% at 1 year and from 63.9% to 83% at 5 years.…”

“…However, since its introduction 20 years ago, only a handful of articles have been published reporting results of this technique. [6][7][8][9][10][11][12][13] This study evaluated the long-term results of RIAE in 2 vascular referral centers and reviewed the existing literature.…”