Analysis of the results of hybrid reconstructive surgeries in patients with critical lower limb ischemia caused by extensive occlusive lesion of the femoropopliteal arterial segment

The OBJECTIVE of our work was to implement and evaluate the results of hybrid reconstructions in the treatment of patients with critical lower limb ischemia caused by extensive occlusive lesions of the femoral and lower leg arteries.
METHODS AND MATERIALS. Over a two-year period, we performed 24 hybrid reconstructions for infrainguinal lesions. The follow-up period was 12 months. 17 patients underwent classic femoropopliteal bypass grafting using the great saphenous vein below the knee joint space and balloon angioplasty of the crural arteries. In 7 patients, a modified operation was performed, including popliteal-distal bypass grafting with an autovein with antegrade semi-closed remote endarterectomy from the superficial femoral artery using balloon angioplasty of the crural artery and, if necessary, stenting of the external femoral artery.
RESULTS. Primary arterial patency over 12 months of follow-up was 83.3 %. Secondary patency was 92 %. Limb preservation was 92 %.
CONCLUSIONS. Hybrid interventions including femoropopliteal autovenous bypass or a modified method (in the absence of a suitable autovein), as well as endovascular correction of outflow tracts, can take a worthy place in the treatment of patients with chronic limb-threatening ischemia, developed against the background of extended occlusive lesions of the femoropopliteal arterial segment.

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