Background: Hybrid approach has been considered as an effective technique for reconstruction of multi-level arterial stenosis or occlusion. The simultaneous combined techniques have shown satisfactory outcomes in terms of patency, technical success and less invasiveness in high-risk patients. The purpose of this study to compare CFA endarterectomy (CFE) combined with either proximal or distal endovascular intervention or both.
Methods: retrospective study of prospectively collected data of patients presented with critical limb threatening ischemia (CLTI) with multi-level peripheral arterial disuses include femoral territory and proximal and/or distal arterial disease. All patients had CFE and endovascular intervention at Egypt healthcare authority hospitals.
Results: this study included 30 patients stratified into three groups according to the site of concurrent endovascular intervention; group 1 had proximal endovascular intervention (n=7); group 2 had distal endovascular intervention (n=12); and group 3 with combined proximal and distal intervention (n = 11), 100% technical success reported with overall primary patency at 24 months of 85%. Limb salvage at 24 months was 92.5%.
Conclusion: Common femoral endarterectomy is the gold standard treatment for common femoral artery lesions with excellent patency. In multi-level peripheral arterial disease, the endovascular intervention could improve the outcome and maintain patency and limb salvage.