Hybrid vascular interventions in the present approach to the treatment of atherosclerotic arterial disease of the lower extremities. Analysis of pathogenetic risk factors and treatment results. Analysis of pathogenetic risk factors and treatment results
https://doi.org/10.24884/0042-4625-2026-185-1-106-113
Abstract
Hybrid vascular surgery represents a promising approach to treating occlusive atherosclerosis, combining endovascular and open surgical methods. This review examines the evolution and definition of hybrid interventions, phenotypic features of multifocal lower extremity arterial disease, outcomes from major trials, contemporary surgical treatment approaches, and prospects for novel interventions, as well as potential complications and their management.
About the Authors
V. A. Sukhoruchkin
North-Western district scientific and clinical center named after L. G. Sokolov
Russian Federation
Competing Interests:
Russian Federation
Sukhoruchkin Vladislav A., Cardiovascular Surgeon
4, Kultury pr., Saint-Petersburg, 194291
Competing Interests:
The authors declare no conflict of interest.
A. V. Svetlikov
North-Western district scientific and clinical center named after L. G. Sokolov; St. Petersburg State University
Russian Federation
Competing Interests:
Russian Federation
Svetlikov Aleksey V., Dr. of Sci. (Med.), Professor of the Department of Hospital Surgery
4, Kultury pr., Saint-Petersburg, 194291
7/9, Universitetskaya embankment, Saint Petersburg, 199034
Competing Interests:
The authors declare no conflict of interest.
V. A. Ratnikov
North-Western district scientific and clinical center named after L. G. Sokolov
Russian Federation
Competing Interests:
Russian Federation
Ratnikov Vyacheslav A., Dr. of Sci. (Med.), Professor, Deputy Director General-Medical Director
4, Kultury pr., Saint-Petersburg, 194291
Competing Interests:
The authors declare no conflict of interest.
P. P. Yablonskiy
St. Petersburg State University
Russian Federation
Competing Interests:
Russian Federation
Yablonskiy Pavel P., Associate Professor of the Department of Hospital Surgery
7/9, Universitetskaya embankment, Saint Petersburg, 199034
Competing Interests:
The authors declare no conflict of interest.
References
1. Kurdyumov G. V., Khandros L. G. On thermoelastic equilibrium in martensitic transformations. Dokl. AN SSSR. 1949;66(2):211–214. (In Russ.).
2. Glyantsev S. P. Professor Joseph Khaimovich Rabkin and his priorities in X-ray endovascular surgery. Angiology and Vascular Surgery. 2014;20(2):21–23. (In Russ.).
3. Troyan V. I. In memory of Professor N. L. Volodos. (In Russ.). URL: https://health-ua.com/article/4846-pamyati-professora-nikolaya-leontevicha-volodosya (accessed: 20.01.2025).
4. Karpenko A. A., Starodubtsev V. B., Chernyavskiy M. A., Ignatenko P. V. Hybrid surgical interventions in patients with chronic lower limb ischemia. Pathology of blood circulation and cardiac surgery. 2012;1:43–46. (In Russ.).
5. Diehm N., Shang A., Silvestro A. et al. Association of cardiovascular risk factors with pattern of lower limb atherosclerosis in 2659 patients undergoing angioplasty. Eur J Vasc Endovasc Surg. 2006;31(1):59–63. https://doi.org/10.1016/j.ejvs.2005.09.006.
6. Tikhonov A. V. Lipoprotein(a) and atherosclerosis. Aterosclerosis. 2007; 3(1):3–23. (In Russ.).
7. Tmoyan N. A., Afanasieva O. I., Ezhov M. V. et al. Lipoprotein(а) Level, Apolipoprotein(а) Polymorphism аnd Autoаntibodies Against Lipoprotein(а) in Patients with Stenotic Cаrotid Atherosclerosis. Kardiologiia. 2019;59(12):20–27. (In Russ.). https://doi.org/10.18087/cardio.2019.12.n727.
8. Temrezov M. B., Kovalenko V. I., Temerezov T. Kh. et al. Hybrid surgery in the treatment of patients with obliterating atherosclerosis of the arteries of the lower extremities (literature review). Translational medicine. 2020;7(1):33–38. (In Russ.). https://doi.org/10.18705/2311-4495-2020-7-1-33-38.
9. Bokeriya L. A., Temrezov M. B., Kovalenko V. I. et al. Surgical treatment of patients with primary critical ischemia of the lower extremities. Annaly hirurgii=Annals of Surgery. 2010;1:16–19. (In Russ.).
10. Chernyavskiy M., Artyushin B., Chernov A. et al. A clinical case of hybrid treatment of a patient with multilevel atherosclerotic lesion of the arteries of the lower extremities. Pathology of blood circulation and cardiac surgery. 2018;22(4):103–110. (In Russ.). https://doi.org/10.21688/1681-3472-2018-4-103-110.
11. Agarkov M. V., Lazakovich D. N., Kozlov K. L. et al. The current state of the problem of surgical treatment of patients with atherosclerotic lesions of the arteries of the lower extremities. Literature review. International Journal of Interventional Cardioangiology. 2023;(75):76–93. (In Russ.). https://doi.org/10.24835/1727-818X-75-76.
12. Best Endovascular vs. Best Surgical Therapy in Patients With Critical Limb Ischemia (BEST-CLI). URL: https://clinicaltrials.gov/study/NCT02060630 (accessed: 28.01.26).
13. Bradbury A. W., Moakes C. A., Popplewell M. et al. A vein bypass first versus a best endovascular treatment first revascularisation strategy for patients with chronic limb threatening ischaemia who required an infrapopliteal, with or without an additional more proximal infra-inguinal revascularisation procedure to restore limb perfusion (BASIL-2): an open-label, randomised, multicentre, phase 3 trial. Lancet. 2023;401(10390):1798–1809. https://doi.org/10.1016/s0140-6736(23)00462-2.
14. Kazakov Yu. I., Lukin I. B., Kazakov A. Yu. et al. The choice of the method of vascular reconstruction in critical ischemia of the lower extremities. Angiology and vascular surgery. 2015;21(2):152–158. (In Russ.).
15. Norgren L., Hiatt W. R., Dormandy J. A. et al. InterSociety consensus for the management of peripheral arteria disease (TASC II). Eur J Vasc Endovasc Surg. 2007;33:S1–S70.
16. Nishibe T., Kondo Y., Dardik A. et al. Hybrid surgical and endovascular therapy in multifocal peripheral TASC D lesions: up to three-year followup. J Cardiovasc Surg (Torino). 2009;50(4):493–9.
17. Conte M. S., Bradbury A. W., Kolh P. et al. Global vascular guidelines on the management of chronic limb-threatening ischemia. Journal of vascular surgery. 2019;69(6S):3S–125S.e40. https://doi.org/10.1016/j.jvs.2019.02.016.
18. Conte, Michael S.Aboyans, Victor et al. Journal of Vascular Surgery. 2019. Vol. 69, № 6. P. 3. https://doi.org/10.1016/j.ejvs.2018.09.020.
19. Ballotta E., Gruppo M., Mazzalai F., Da Giau G. Common femoral artery endarterectomy for occlusive disease: an 8-year single-center prospective study. Surgery. 2010. Vol. 147, № 2. P. 268–74. https://doi.org/10.1016/j.surg.2009.08.004.
20. Dzhurakulov Sh. R. Endovascular treatment of patients with advanced atherosclerotic lesions of the aorta and arteries of the lower extremities: dissertation of Doctor of Medical Sciences: 14.01.26 / Pirogov National Medical and Surgical Center of the Ministry of Health of the Russian Federation, 2017. 112-114 p. (In Russ.).
21. Gavrilenko A. V., Kravchenko A. A., Kotov A., Shatalova D. V. Treatment of patients with critical lower limb ischaemia: endovascular methods or reconstructive operations. Angiol Sosud Khir. 2017;23(3):145–150. (In Russ.).
22. Clinical Practice Guideline Document. 2019. Vol. 69, Issue 6, Supplement , 3S-125S.E40. URL: https://www.jvascsurg.org/article/S0741-5214(19)30321-0/fulltext (accessed: 20.01.26).
23. Vachev A. N., Sukhorukov V. V., Dmitriev O. V., Krugomov A. V. Sequence of stages of hybrid operations in patients with Leriche syndrome and critical limb ischaemia. Angiol Sosud Khir.2016;22(1):159–64. (In Russ.).
24. Glushkov N. I., Ivanov M. A., Apresyan A. Yu. et al. Are hybrid technologies appropriate for revascularization of aortoiliac-femoral segment? Pirogov Russian Journal of Surgery = Khirurgiya. Zurnal im. N. I. Pirogova. 2020;8:49–54. (In Russ.). https://doi.org/10.17116/hirurgia202008149.
25. Hou D., Huibregtse B., Eppihimer M. et al. Fluorocopolymer-coated nitinol self-expanding paclitaxel-eluting stent: pharmacokinetics and vascular biology responses in a porcine iliofemoral model. EuroIntervention. 2016;12(6):790–797.
26. Grube E. STEALTH I: safety and performance evaluation of biosensors Biolimus A9TM international drugeluting stent (Bio-MatrixTM): a 4-year safety follow-up [Electronic resource]. TCT 2008: Transcatheter Cardiovascular Therapeutics 20th Annual Scientific Symposium (12-17 Oct, 2008). URL: https://www.medscape.com/viewcollection/17472 (accessed: 15.01.2026).
27. Kuznetsov K. A., Kharkova M. V., Karpenko A. A., Laktionov P. P. Vascular stents: approaches used to improve their clinical effectiveness. Angiology and vascular surgery. 2018;24(2):69–79. (In Russ.).
28. Kochergin N. A., Kochergina A. M. Potential of optical coherence tomography and intravascular ultrasound in the detection of vulnerable plaques in coronary arteries. Cardiovascular Therapy and Prevention. 2022;21(1):2909. (In Russ.).
Review
For citations:
Sukhoruchkin V.A., Svetlikov A.V., Ratnikov V.A., Yablonskiy P.P. Hybrid vascular interventions in the present approach to the treatment of atherosclerotic arterial disease of the lower extremities. Analysis of pathogenetic risk factors and treatment results. Analysis of pathogenetic risk factors and treatment results. Grekov's Bulletin of Surgery. 2026;185(1):106-113. (In Russ.) https://doi.org/10.24884/0042-4625-2026-185-1-106-113
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