The Outcome Comparison of Hybrid and Nonhybrid Revascularization With Acute Lower Limb Ischemia

The treatment of choice for acute limb ischemia (ALI) remains a topic of debate. Most studies on treatment for ALI have compared surgical and endovascular revascularization, with few studies investigating the benefits of hybrid revascularization.

In the present study, the 30-day and 1-year outcomes of three revascularization methods in patients with primary native ALI were analyzed. The data on patients treated for ALI between January 2002 and June 2022 were collected from a single medical institute. Three methods for the treatment of ALI were analyzed. The demographics, preoperative status, and perioperative and postoperative outcomes of the patients were analyzed, and the risk factors for 30-day amputation, mortality, and 1-year follow-up were identified.

Single revascularization method and higher creatine kinase were the risk factor for 30-day amputation (odds ratio [OR]: 2.67, confidence interval [CI]: 1.06-6.71, P = 0.037 for endovascular method; OR: 2.28, CI: 1.08-4.83, P = 0.031 for surgical method, reference by hybrid method; OR: 3.43, CI: 1.58-7.44, P = 0.002 for higher creatine kinase). At 1-year amputation-free rate, the hybrid method was higher than the surgical and endovascular methods (81.8% versus 79.6%, P = 0.424; 81.8% versus 64.7%, P = 0.031) CONCLUSIONS: Hybrid revascularization has an acceptable immediate complication rate and a lower 30-day and 1-year amputation rate than surgical and endovascular revascularization. In addition, no significant differences were observed between the three forms of revascularization in terms of reintervention-free, overall survival, and amputation-free survival rates at 1-year follow-up.