Hybrid therapeutic procedures for patients with acute lower limb ischemia / 中华普通外科杂志

ABSTRACT

Objective To compare surgical hybrid procedures (open thromboembolectomy/bypass,transluminal angioplasty/stenting) and endovascular hybrid procedures (percutaneous mechanical thrombectomy,catheter-directed intra-arterial thrombolysis,transluminal angioplasty/stenting) in patients with acute lower limb ischemia.Methods From June 2011 to June 2012,the clinical data and the six month follow-up data of patients with acute (less than 14 days) lower limb ischemia were collected and analyzed,who have underwent the endovascular modality hybrid procedures (endovascular modality group)or surgery modality of hybrid procedures (surgery modality group).The combined incidence of perioperative (30 days) death (POD) and major adverse limb event (MALE,include amputation or major intervention again) was defined as the primary end-point,and the secondary efficacy end-point was major adverse cardiovascular event (MACE) consisted of myocardial infarction,stroke and death from any cause.Results There were 105 and 95 cases respectively in the endovascular modality group and the surgery modality group.96 patients (99.0％) in the surgery modality group and 97 patients (92.4％) in the endovascular modality group were successfully completed with vascular reconstruction.The incidence of the primary end-point (combined POD and MALE) in the surgery modality group (7.2％) was significantly less than the endovascular modality group (17.1％).Hemorrhagic complications occurred more in the endovascular modality group (6.7％) than the surgery modality group (0％).The surgery modality group had more postoperative pulmonary complications (9.3％) than the endovascular modality group (1.0％).Conclusions Surgical hybrid procedures offer better immediate and mid-term results for patients with acute lower limb ischemia.