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01-10-2020 | Endarterectomy | Original Scientific Report

A Retrospective Comparison Between Hybrid Treatment and Prosthetic Above-the-Knee Femoro-Popliteal Bypass in the Management of the Obstructive Disease of the Superficial Femoral Artery

Authors: Walter Dorigo, Gabriele Piffaretti, Aaron Fargion, Nicola Rivolta, Ruth L. Bush, Elena Giacomelli, Chiara Guttadauro, Patrizio Castelli, Carlo Pratesi

Published in: World Journal of Surgery | Issue 10/2020

Abstract

Objective

We assessed early and late outcomes following hybrid intervention (common femoral artery endarterectomy and superficial femoral artery (SFA) stenting) versus above-the-knee (AK) femoro-popliteal bypass performed for peripheral artery occlusive disease (PAOD) in a double-center retrospective comparative cohort study.

Materials and methods

From January 2006 to December 2017, 82 hybrid revascularizations with femoral endarterectomy and SFA stenting (HY Group) and 98 AK femoro-popliteal bypasses with femoral endarterectomy (BP Group) were performed at two academic vascular centers. The two groups were compared in terms of preoperative and intraoperative details and of perioperative (<30 days) outcomes with χ² test. Long-term results were compared using Kaplan–Meier curves and log-rank test.

Results

No differences were found in demographics variables, risk factors, comorbidities and clinical presentation between the two groups. Also perioperative outcomes were similar between the two groups. Median duration of follow-up was 38 months. At five years, the estimated survival rate was 60% in HY Group and 77.5% in BP Group (p = 0.002) Five-year primary patency rates were 46% in HY Group and 64% in BP Group (p = 0.005). Overall, 13 patients in HY Group required conversion to open surgery and 6 patients in BP Group underwent below-knee (n = 4) or distal (n = 2) bypass. The 5-year rate of limb maintenance was 85% in HY Group and 94% in BP Group (p = 0.1) and was not significantly different regardless of presentation, claudication or critical limb ischemia.

Conclusions

In patients with PAOD due to complex long lesions of the infrainguinal arteries, open-surgical treatment with AK bypass provided better long-term survival and patency rates compared to a hybrid approach.

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Title: A Retrospective Comparison Between Hybrid Treatment and Prosthetic Above-the-Knee Femoro-Popliteal Bypass in the Management of the Obstructive Disease of the Superficial Femoral Artery
Authors: Walter Dorigo
Gabriele Piffaretti
Aaron Fargion
Nicola Rivolta
Ruth L. Bush
Elena Giacomelli
Chiara Guttadauro
Patrizio Castelli
Carlo Pratesi
Publication date: 01-10-2020
Publisher: Springer International Publishing
Keyword: Endarterectomy
Published in: World Journal of Surgery / Issue 10/2020
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-020-05616-w

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

A Retrospective Comparison Between Hybrid Treatment and Prosthetic Above-the-Knee Femoro-Popliteal Bypass in the Management of the Obstructive Disease of the Superficial Femoral Artery

Abstract

Objective

Materials and methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objective

Materials and methods

Results

Conclusions

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