title: A new endovascular strategy utilizing a hybrid procedure for long segmental occlusion by acute arterial thromboembolism in the lower extremity.
abstract: OBJECTIVE
  To evaluate a new endovascular strategy utilizing a hybrid procedure for long segmental arterial thromboembolism in a lower extremity by historical comparison with conventional endovascular strategy.
  
  
  METHODS
  In a new endovascular strategy, a hybrid procedure was performed for long segmental thromboembolism (longer than 15 cm) and an endovascular procedure for short segmental thromboembolism. The new strategy group (Group A) consisted of 24 procedures (13 hybrid procedures, 11 endovascular procedures) in 19 patients. Data were retrospectively collected from 24 consecutive procedures in 23 patients treated with the conventional strategy (Group B).
  
  
  RESULTS
  The technical success of Groups A and B was 24/24 and 20/24, respectively (p = 0.11). Major amputation or mortality was not observed in Group A, whereas 3 major amputations and 4 deaths occurred in Group B. Clinical failure in Groups A and B was 0/24 and 7/24, respectively (p < 0.05). Continuous urokinase (UK) infusion was needed in 1/24 in Group A and 14/24 in Group B (p < 0.05). Mean procedure time was 4 h 17 min for Group A and 21 h 30 min for Group B (p < 0.05).
  
  
  CONCLUSIONS
  The hybrid procedure may be faster and more effective than the conventional treatment in long segmental arterial thromboembolisms, while the conventional treatment is still effective for short segmental occlusions.
authors.affiliation: Department of Radiology, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-Si, Gyeonggi-do, 425-707, Korea.
authors.forename: JungWon
authors.initials: J
authors.lastname: Kwak
authors.affiliation: Department of Radiology, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-Si, Gyeonggi-do, 425-707, Korea. chungmic@korea.ac.kr.
authors.forename: HwanHoon
authors.initials: H
authors.lastname: Chung
authors.affiliation: Department of Radiology, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-Si, Gyeonggi-do, 425-707, Korea.
authors.forename: SeungHwa
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Radiology, Korea University Anam Hospital, Seoul, Korea.
authors.forename: YunHwan
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Department of Radiology, Korea University Anam Hospital, Seoul, Korea.
authors.forename: SungBum
authors.initials: S
authors.lastname: Cho
authors.affiliation: Department of Radiology, Korea University Guro Hospital, Seoul, Korea.
authors.forename: TaeSuk
authors.initials: T
authors.lastname: Seo
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-Si, Gyeonggi-do, 425-707, Korea.
authors.forename: Wonmin
authors.initials: W
authors.lastname: Jo
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-Si, Gyeonggi-do, 425-707, Korea.
authors.forename: JaeSeung
authors.initials: J
authors.lastname: Shin
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage; D000072226:Computed Tomography Angiography; D057510:Endovascular Procedures / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage; D035002:Lower Extremity / Q000098:blood supply* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D012189:Retrospective Studies; D013923:Thromboembolism / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine; D014568:Urokinase-Type Plasminogen Activator
keywords: Acute arterial thromboembolism; Endovascular treatment; Thrombectomy; Thrombolysis