Background. Thrombectomy (TE) is an effective treatment for acute limb ischemia (ALI).
However,residual thrombus and chronic occlusive-stenotic lesions may limit clinical success rate.The
“hybrid procedures” allow identification of underlying lesions and its simultaneous endovascular
correction Objective of the study. The aim of study was evaluation of first experience and early results
of HP performed on emergency basis in patients with ALI Material and Methods. Our initial
experience includes 3 patients with ALI grade IIB of lower limbs who underwent urgent staged HP. The
indications for HP was suboptimal result of TE. The immediate technical success was defined as patent
artery with <30% residual stenosis. Primary patency, limb salvage rate and value of ankle brachial
pressure index (ABPI) were defined as clinical outcomes Results. Open surgery consisted of TE from
iliac artery in 1 case and from femoral-popliteal segment in 2 cases. In first case angiography revealed
the severe stenosis of common iliac artery and in other two cases - chronic occlusions of tibial arteries.
Endovascular stage of HP included: transluminal angioplasty and stenting of common iliac artery in one
case and angioplasty of tibial arteries in two. Technical success was achieved in all cases. In the
postoperative period the median value of ABPI increased with 0,64. At six-months follow-up the
primary patency and limb salvage rates were 100%, and survival rate was 66% Conclusion. Initial
experience of HP in patients with ALI offered promising results, demonstrating its feasibility, sufficient
efficacy and safety, especially in cohort of high-risk patients. HP for ALI should be implemented in
routine practice and evaluated in larger clinical studies.
Background. Thrombectomy (TE) is an effective treatment for acute limb ischemia (ALI).
However,residual thrombus and chronic occlusive-stenotic lesions may limit clinical success rate.The
“hybrid procedures” allow identification of underlying lesions and its simultaneous endovascular
correction Objective of the study. The aim of study was evaluation of first experience and early results
of HP performed on emergency basis in patients with ALI Material and Methods. Our initial
experience includes 3 patients with ALI grade IIB of lower limbs who underwent urgent staged HP. The
indications for HP was suboptimal result of TE. The immediate technical success was defined as patent
artery with <30% residual stenosis. Primary patency, limb salvage rate and value of ankle brachial
pressure index (ABPI) were defined as clinical outcomes Results. Open surgery consisted of TE from
iliac artery in 1 case and from femoral-popliteal segment in 2 cases. In first case angiography revealed
the severe stenosis of common iliac artery and in other two cases - chronic occlusions of tibial arteries.
Endovascular stage of HP included: transluminal angioplasty and stenting of common iliac artery in one
case and angioplasty of tibial arteries in two. Technical success was achieved in all cases. In the
postoperative period the median value of ABPI increased with 0,64. At six-months follow-up the
primary patency and limb salvage rates were 100%, and survival rate was 66% Conclusion. Initial
experience of HP in patients with ALI offered promising results, demonstrating its feasibility, sufficient
efficacy and safety, especially in cohort of high-risk patients. HP for ALI should be implemented in
routine practice and evaluated in larger clinical studies.
