Abstract
Background: The aim of this study was to investigate the efficacy of “hybrid revascularization”, which consists of iliac endovascular surgery together with minimally invasive bypass grafting for arteriosclerosis of the leg. Methods: We studied 144 consecutive patients given a diagnosis of aortoiliac occlusive disease (AIOD) between 1998 and 2006. Their mean age was 69 years old. The study patients were classified according to sites of arterial sclerotic lesions. Results: The patient group consisted of 100 cases of segmental distal lesions and 44 cases of extended distal lesions. More patients with extended distal lesions initially presented with critical limb ischemia than those with segmental distal lesions (93% vs. 38%; P<0.01). Furthermore, the frequencies of hemodialysis treatment (39% vs. 17%; P < 0.01), previous history of cerebrovascular disease (59% vs. 41%; P < 0.05) and major amputation (48% vs. 4%; P < 0.01) were significantly higher among the patients with extended distal lesions than those with segmental distal lesions. A total of 74 patients underwent revascularization, including conventional bypass operation in 47 patients, iliac PTA/stent alone in 10, and PTA/stent and distal bypass grafting in 17. A transperitoneal approach was used in 27 of 47 patients undergoing conventional revascularization. Five of them had postoperative respiratory complications while no patients undergoing hybrid revascularization had such complications. Conclusion: Our results suggested that the patients who have AIOD with extended distal lesions may benefit more from the hybrid revascularization.
