Outcome after Hybrid Outflow Interventions for Chronic Limb-threatening Ischemia
J Serna Santos1, M Söderström1, R Helminen1
1Department of Vascular Surgery, Helsinki University Hospital, Helsinki, Finland.
Summary
Hybrid revascularization combining open surgery and angioplasty effectively treats chronic limb-threatening ischemia (CLTI) with multilevel arterial disease, achieving high limb salvage rates.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Endovascular Therapy
Background:
- Chronic limb-threatening ischemia (CLTI) often involves multilevel arterial disease requiring complex revascularization.
- Multilevel disease necessitates interventions at various sites within the limb vasculature.
Purpose of the Study:
- To evaluate the outcomes of hybrid interventions combining open surgical revascularization with outflow segment percutaneous transluminal angioplasty (PTA).
- To assess the efficacy of this hybrid approach in patients suffering from CLTI.
Main Methods:
- Retrospective analysis of 80 hybrid outflow-PTA interventions performed between 2003 and 2015 for CLTI.
- Patient data were collected prospectively and analyzed retrospectively with a follow-up ending December 2019.
- Common procedures included femoral endarterectomy and superficial femoral artery PTA.
Main Results:
- High limb salvage rates: 92% at 30 days, 91% at 1 year, and 86% at 5-10 years.
- Survival and amputation-free survival rates were 93% and 86% at 30 days, respectively.
- Wound healing rates reached 87% by 12 months, with 72% freedom from target lesion revascularization at 5 years.
Conclusions:
- Hybrid outflow revascularization is a valuable strategy for managing CLTI patients with multilevel arterial disease.
- This approach offers significant limb salvage and improved patient outcomes.
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