title: Hybrid endarterectomy and endovascular therapy in multilevel lower extremity arterial disease involving the femoral artery bifurcation.
abstract: The objective of this study was to evaluate the feasibility and efficacy of hybrid therapy (combined endarterectomy-endovascular) in patients with complex peripheral multifocal steno-obstructive vascular disease involving the femoral artery bifurcation. Forty-one combined procedures were performed on 40 patients. Although the common femoral artery was usually treated with endarterectomy, endoluminal procedures were performed proximally in 12 patients (group 1), distally in 18 patients (group 2), and both upward and downward in 11 patients (group 3). Patients underwent clinical assessment and ankle-brachial index measurement thereafter. Primary, assisted-primary, and secondary patency rates at 24 months were 59%, 66%, and 72%, respectively. Primary patency rates were lower in group 3 compared with groups 1 and 2 (P  =  0.015). The limb salvage rate was 86.4% at the end of the follow-up period. Hybrid procedures provide feasible and effective treatment management of selected patients with multilevel lower extremity arterial disease involving the femoral artery bifurcation.
authors.affiliation: Division of Vascular Surgery, First Affiliated Hospital of Nanjing Medical University, Nanjing City, Jiangsu Province, China.
authors.forename: Junjie
authors.initials: J
authors.lastname: Zou
authors.forename: Yongxiang
authors.initials: Y
authors.lastname: Xia
authors.forename: Hongyu
authors.initials: H
authors.lastname: Yang
authors.forename: Hao
authors.initials: H
authors.lastname: Ma
authors.forename: Xiwei
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000295:instrumentation / Q000379:methods*; D001162:Arteriosclerosis Obliterans / Q000601:surgery*; D003131:Combined Modality Therapy; D004691:Endarterectomy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000601:surgery*; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome