Long-Term Results of a Hybrid Revascularization Procedure for Peripheral Arterial Disease.

Jun Okadome, Takuya Matsumoto, Y. Aoyagi, Daisuke Matsuda, Shinichi Tanaka, Eisuke Kawakubo, R. Kyuragi, K. Morisaki, Kenichi Homma, K. Iwasa, T. Ohmine, A. Guntani, Ryota Fukunaga, Y. Maehara
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引用次数: 5

Abstract

OBJECTIVE To evaluate the efficacy of hybrid procedure for peripheral arterial disease (PAD), we compared the cases treated using the hybrid procedure with those treated using open revascularization (bypass alone) in our facilities. MATERIALS AND METHODS We retrospectively reviewed 204 patients who underwent revascularization for PAD between 2007 and 2013. We divided the patients into two groups based on the type of procedure. Group 1 included patients who underwent the hybrid procedure, that is, doing endovascular therapy (EVT) either femoral or iliac resion and added the bypass procedure (infragenicular vein bypass) to the below knee artery, and group 2 included patients who underwent only bypass procedure (used autovein), that is, central anastomotic region was femoral artery region and peripheral anastomotic region was below knee artery. We evaluated various factors between the two groups, including the primary patency rate, secondary patency rate, amputation-free survival rate, and determined the efficacy of the hybrid procedure for PAD. RESULTS In the patient's characteristics, there was significant difference between the two groups in the cases with cerebrovascular disease, only (p = 0.03). There were no significant differences in the primary or secondary patency rates, and the amputation-free survival rate. CONCLUSIONS Primary patency rate, secondary patency rate, and amputation-free survival rate of the hybrid procedure were comparable to those of bypass (alone) procedure. The hybrid procedure is therefore an acceptable strategy for patients with PAD.
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外周动脉疾病混合型血运重建术的长期疗效。
目的评价混合手术治疗外周动脉疾病(PAD)的疗效,比较我院采用混合手术治疗外周动脉疾病(PAD)的病例与采用开放血运重建术(单独旁路)治疗的病例。材料与方法我们回顾性分析了2007年至2013年间接受PAD血运重建术的204例患者。我们根据手术方式将患者分为两组。组1为混合型手术,即行股动脉或髂血管内治疗(EVT),并在膝下动脉上加搭桥手术(细静脉搭桥);组2为仅行搭桥手术(自体静脉),即中央吻合区为股动脉区域,外周吻合区为膝下动脉。我们评估了两组间的各种因素,包括原发性通畅率、继发性通畅率、无截肢生存率,并确定混合手术治疗PAD的疗效。结果两组在脑血管疾病患者的特征上差异有统计学意义(p = 0.03)。原发性和继发性通畅率及无截肢生存率无显著差异。结论混合手术的一次通畅率、二次通畅率和无截肢生存率与单纯旁路手术相当。因此,混合手术是PAD患者可接受的策略。
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