title: [Hybrid procedures for multilevel femoral and popliteal artery occlusive disease].
abstract: OBJECTIVE
  To evaluate the immediate and mid-term effectiveness of hybrid procedures (combined open surgery and endovascular therapy) for multilerel femoral and popliteal artery occlusive disease.
  
  
  METHODS
  Between June 2009 and June 2012, 22 cases of severe femoral and popliteal artery occlusive disease were treated by hybrid surgery. There were 15 men and 7 women with an age range of 52-78 years (mean, 66.2 years) and with a disease duration of 6 months to 5 years (mean, 1.5 years). Of 22 patients, 13 had a history of smoking; 8 were classified as Fontaine III and 14 as Fontaine IV. The complications included diabetes (8 patients), hypertension (16 patients), hyperlipemia (10 patients), coronary heart disease (11 patients), and chronic kidney failure (1 patient). Patency analyses were performed using Kaplan-Meier life tables and log-rank test.
  
  
  RESULTS
  All patients underwent successfully procedures. The time of operation was 70-160 minutes (mean, 137 minutes). Acute myocardial infarction, hematoma of incision, fracture of stent, and stent thrombosis occurred in 1 case, respectively. At 6 months after surgery, the ankle brachial index (ABI), the transcutaneous oxygen pressure (TcpO2), and the average intermittent claudication distance were significantly increased when compared with preoperative ones [0.79 +/- 0.33 versus 0.32 +/- 0.18, (42.7 +/- 15.7) kPa versus (17.6 +/- 11.6) kPa, and (420 +/- 80) m versus (160 +/- 54) m, P < 0.05]. The patients were followed up 6-24 months (mean, 14.5 months). The primary patency rate, primary assisted patency rate, and second patency rate were 77.3% (17/22), 90.9% (20/22), and 95.5% (21/22) respectively, showing no significant difference among them (P > 0.05). No significant difference was found in various-stage patency rates between patients at Fontaine III and IV (P > 0.05).
  
  
  CONCLUSIONS
  Hybrid procedures provide an effective treatment of multilevel femoral artery and popliteal artery disease while there is good outflow.
authors: Department of Vascular and Endovascular Surgery, the Second Affiliated Hospital of Nanjing Medical University, Nanjing Jiangsu, 210000, P.R.China. wzqnju@aliyun.com
authors: Zhiqing
authors: Z
authors: Wei
authors: Department of Vascular and Endovascular Surgery, the Second Affiliated Hospital of Nanjing Medical University, Nanjing Jiangsu, 210000, P.R.China.
authors: Qipeng
authors: Q
authors: Yang
authors: Department of Vascular and Endovascular Surgery, the Second Affiliated Hospital of Nanjing Medical University, Nanjing Jiangsu, 210000, P.R.China.
authors: Jieming
authors: J
authors: Gong
authors: Department of Vascular and Endovascular Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School.
authors: Changjian
authors: C
authors: Liu
mesh_terms: D000368:Aged; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D004691:Endarterectomy; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005263:Femoral Artery / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000628:therapy; D012720:Severity of Illness Index; D016896:Treatment Outcome