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Kim, Joo, and Park: Results of Simultaneous Hybrid Operation in Multi-level Arterial Occlusive Disease
Original Article
Journal of the Korean Surgical Society

Journal of the Korean Surgical Society 2010; 79(5): 386-392.

Published online: 12 November 2010

DOI: https://doi.org/10.4174/jkss.2010.79.5.386

Results of Simultaneous Hybrid Operation in Multi-level Arterial Occlusive Disease

Min Su Kim, M.D., Yoon Sung Joo, M.D., Ki Hyuk Park, M.D.

Division of Vascular/Endovascular Surgery, Department of Surgery, Daegu Catholic University Medical Center, Daegu, Korea.

Corresponding author (winderror@yahoo.co.kr)

Received 19 April 2010       Accepted 27 July 2010

Copyright © 2010 The Korean Surgical Society

Abstract

Purpose

Hybrid procedure in lower extremity arterial disease is composed of open bypass and endovascular treatment. For proximal inflow bypass operations for distal lesions used to be performed 1 or 2 weeks after endovascular therapy. Since Aug 2005, all hybrid operations have been performed simultaneously in the operation room in our center. In this study, we compared the results of the staged hybrid operations with those of simultaneous procedures.

Methods

From Jan 1999 to Dec 2009, 115 endovascular treatments and 139 bypass operations were performed. 44 bypasses were performed 1 day to 14 days after angioplasty in inflow lesions (group I) and 95 bypasses were performed simultaneously in the operation room with mobile fluoroscopy (group II). In both groups, inflow procedures included 3 femoral balloon angioplasties, 3 femoral stents, 24 iliac balloon angioplasties and 85 iliac stents. Bypass operations were composed of 39 femorofemoral and 102 infrainguinal bypasses including 60 femoropopliteal and 42 other bypasses.

Results

The 3-year patency rate of bypass graft is 71.5%. There is no difference in either group. But in endovascular treatment lesion, the 3-year patency rate is 80% and that of the simultaneous group is higher than that of the staged group (P<0.05).

Conclusion

Hybrid operation is a less invasive therapy for revascularization in multilevel peripheral arterial occlusive disease. With development of endovascular therapy, simultaneous hybrid operations become more efficient.

Keywords: Hybrids, Multilevel peripheral artery disease, Endovascular treatment, Bypass surgery

Figures and Tables

Fig. 1
Comparison of 3-year cumulative primary patency rates in endovascular treatment for iliac lesion between staged and simultaneous group.
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Fig. 2
Comparison of 3-year cumulative primary patency rates in femoropopliteal bypass grafts between staged and simultaneous group.
jkss-79-386-g002
Fig. 3
Comparison of 3-year limb salvage rates between staged and simultaneous group.
jkss-79-386-g003
Fig. 4
Wound hematoma due to previous puncture injury (black arrow).
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Table 1
Patient characteristics
jkss-79-386-i001

*Compared to staged group; †ABI = ankle/brachial systolic pressure index.

Table 2
TASC II classification and treatment methods
jkss-79-386-i002

*Compared to staged group.

Table 3
Results of hybrid treatment in both groups
jkss-79-386-i003

*ABI = ankle/brachial systolic pressure index.

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