Hybrid Technique: Common Femoral Artery Endarterectomy and Endovascular Therapy in Critical Lower Limb Ischemia

Abstract

Introduction: Multilevel arterial occlusive disease in patients with chronic limb threatening ischemia (CLTI) represent a major revascularisation challenge to vascular surgeons. The goal of treatment is a single intervention procedure that results in an excellent technical success without associated complications or the need for further interventions. Methods: Prospective case series study including (30) patients complaining from critical lower limb ischemia (rest pain or tissue loss) and has CFA lesionwith proximal or distal lesions. All patients undergoing common femoral Endarterectomy and endovascular therapy to proximal or distal lesions between May 2018 and December 2020. The study was conducted at the department of vascular and endovascular surgery in Mansoura university hospitals Results: Femoral Endarterectomy was performed in all cases in the current cohort with combined iliac and SFA revascularization in 27% of patients and with separate iliac in 10% and outflow in 63% of cases (SFA 33% and tibial 30%). This study reported a 100% technical success and 96% hemodynamic and clinical success in the current series. And the 2-year patency was 88% Conclusion CFE should remain the treatment of first choice of CFA occlusive disease as it is safe, effective, and durable procedure for common femoral artery disease, and the simultaneous hybrid CFA endarterectomy and endovascular therapy for multilevel occlusive artery disease can provide an immediate satisfactory results, durable midterm patency, and also less invasive therapeutic option in high-risk patients.