[Hybrid surgical and endovascular therapy in TASC type D XXXX : a retrospective analysis of 48 cases].

@entity1 @entity455 @entity6 @entity63 @entity731
OBJECTIVE: to retrospectively analyze 4-year results after hybrid (combined surgical-endovascular) therapy in @entity1 with complex peripheral TASC type D @entity731 . METHODS: from January 2006 to December 2009, 48 lower limbs in 46 @entity1 with TASC type D @entity731 were treated by hybrid surgical and endovascular therapy. There were 32 male and 16 female, age ranged from 54 to 85 years with an average of 67 years. The early clinical results were determined by ankle brachial index (ABI) and intermittent claudication distance. Patency analyses were performed using Kaplan-Meier life tables. Univariate and multivariate analyses were used to assess the influence of various risk factors on primary patency. RESULTS: all lower limbs underwent successful hybrid surgical and endovascular therapy. The average ABI before and after hybrid therapy were 0.63    0.18 and 0.24    0.13 (P < 0.05). The average intermittent claudication distance significantly increased from (87    48) m to (247    62) m (P < 0.05). The mean duration of follow-up was 21.7 months (ranging 1 to 46 months). Over all, the primary patency rates, primary assisted patency rates and second patency rates were 79.2%, 83.3% and 95.8% respectively. The primary patency rate for intermittent claudication was significantly higher than that for @entity63 (P < 0.05). Primary patency rates were lower in @entity1 who underwent open surgery with both proximal and distal endoluminal procedures when compared with endovascular reconstruction proximal or distal to the site of open reconstruction (P < 0.05). The presence of @entity6 and dyslipidaemia were independent predictors of decreased primary patency rate (P = 0.013 and P = 0.008, respectively). CONCLUSIONS: Hybrid procedures provide an effective treatment management of selected @entity1 with multilevel lower extremity @entity455 .
