[Open and hybrid interventions in steno-occlusive lesions of the iliac-femoral segment (TASC C, D): intermediate results].

Abstract

According to the data of various statistical studies, 76% of patients with occlusion of the aortoiliac arterial bed are found to have lesions of the femoropopliteal segment. Surgical treatment of patients presenting with multi-layered atherosclerotic lesions still remains one of the most complicated problems of vascular surgery, since adequate revascularization of lower limbs requires correction of the inflow and outflow pathways. In the early postoperative period in patients with lower limb ischemia with multilevel lesions, as well as while performing conventional open reconstructions on the aortoiliac segment, the complication rates still remain high. Presented in the article are the results of a single-center randomized study comparing a hybrid procedure and aortofemoral bypass grafting for lesions of iliac arteries and the common femoral artery. All patients were enrolled into the study according to inclusion and exclusion criteria. The duration of follow up amounted to 24 months. The obtained findings demonstrated safety of the hybrid procedure in the early postoperative period, as well as a shorter length of hospital stay. High efficacy of hybrid operative interventions: clinical improvement in 92-98% of cases with low incidence of postoperative complications make promising the development of this direction of reconstructive vascular surgery in this cohort of patients as compared with aortofemoral bypass grafting. Our study was aimed at revising the guidelines on endovascular treatment of TASC II type C/D lesions of the aortoiliac segment, as well as implementing hybrid techniques in treatment of this cohort of patients.