title: Hybrid treatment of lower limb critical ischemia in a patient with systemic lupus erythematosus.
abstract: Systemic lupus erythematosus (SLE) is a chronic inflammatory multisystemic disease, which affects primarily small-sized vessels, arterioles, venules, and capillaries in the cardiovascular system. Less often, medium-sized vessels are affected, and large-sized vessels are affected rarely. We report an unusual case of a 52-year-old female patient with SLE under treatment and multileveled arterial obstructive disease of the lower limb, who presented with critical limb ischemia. The patient was treated using a hybrid endovascular and open revascularization procedure, on the basis of the clinical picture of the patient, the angiographic findings, and the experience of our department. Our aim is not only to highlight the rarity of the clinical picture but also to make useful conclusions regarding the proper management for such unusual cases. Given the fact that there are no guidelines, we present the treatment strategy selected for our patient and discuss our results.
authors.affiliation: Department of Vascular Surgery, "KAT" General Hospital of Athens, Athens, Greece.
authors.forename: Sotirios
authors.initials: S
authors.lastname: Giannakakis
authors.affiliation: Department of Vascular Surgery, "KAT" General Hospital of Athens, Athens, Greece. Electronic address: georgegalyfos@hotmail.com.
authors.forename: George
authors.initials: G
authors.lastname: Galyfos
authors.affiliation: Department of Vascular Surgery, "KAT" General Hospital of Athens, Athens, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Stefanidis
authors.affiliation: Department of Vascular Surgery, "KAT" General Hospital of Athens, Athens, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Kastrisios
authors.affiliation: Department of Vascular Surgery, "KAT" General Hospital of Athens, Athens, Greece.
authors.forename: Chrisostomos
authors.initials: C
authors.lastname: Maltezos
mesh_terms: D015901:Angiography, Digital Subtraction; D000800:Angioplasty, Balloon / Q000295:instrumentation; D003131:Combined Modality Therapy; D016638:Critical Illness; D005260:Female; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D035002:Lower Extremity / Q000098:blood supply*; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000175:diagnosis; D008875:Middle Aged; D012039:Regional Blood Flow; D012501:Saphenous Vein / Q000637:transplantation*; D015607:Stents; D016896:Treatment Outcome; D014654:Vascular Patency