Repository logo
 
Publication

Hybrid surgery in lower limb revascularization : a real-world experience from a single center

2019-10Journal article Restricted access
Simple item page
dc.contributor.authorSoares, Tony
dc.contributor.authorManuel, Viviana
dc.contributor.authorAmorim, Pedro
dc.contributor.authorMartins, Carlos
dc.contributor.authorMelo, Ryan
dc.contributor.authorMinistro, Augusto
dc.contributor.authorSobrinho, Gonçalo
dc.contributor.authorSilvestre, Luís
dc.contributor.authorFernandes E Fernandes, Ruy
dc.contributor.authorPedro, Luís M
dc.date.accessioned2020-12-15T17:34:14Z
dc.date.available2020-12-15T17:34:14Z
dc.date.issued2019-10
dc.description© 2019 Elsevier Inc. All rights reserved.pt_PT
dc.description.abstractBackground Through the association of endovascular and open procedures, hybrid surgery for lower limb revascularization allows the treatment of multilevel occlusive disease with a lower risk when compared to extensive open interventions. The aim of this study is to evaluate the immediate and midterm clinical outcomes of hybrid techniques for lower limb revascularization in a cohort of patients with multilevel arterial disease. Methods Data from elective procedures between 2012 and 2017 were retrospectively collected regarding hybrid lower limb revascularization procedures. The outcomes of the study were categorical clinical improvement, patency rates, major amputation rates, and mortality. Results A total of 81 patients, 89 limbs, with a median age of 69 years (interquartile range [IQR] 61–73) were submitted to hybrid lower limb revascularization, with a median follow-up of 10.7 months (IQR 2.5–25.1). Treatment indications were chronic limb-threatening ischemia in 80.9% of the cases (rest pain in 18.0% and tissue loss in 62.9%). One-year primary, primary-assisted, and secondary patency rates were 78.28% (95% confidence interval [CI] 65.20–86.92), 85.12% (95% CI 72.96–92.09), and 90.19% (95% CI 79.13–95.54), respectively. Overall categorical clinical improvement was observed in 56.2%. Major amputation and mortality rates were 14.6% and 16.0%, respectively. Multilevel Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC) C or D and stage IV Leriche-Fontaine classification were strongly associated with decreased categorical clinical improvement (adjusted odds ratio [aOR] 0.08, P < 0.0001 and aOR 0.25, P = 0.013, respectively). Multilevel TASC C or D was also related to higher amputation rates, contrary to clinical presentation (adjusted hazard ratio [aHR] 11.37, P = 0.002 and aHR 4.70, P = 0.091, respectively). Primary-assisted and secondary patency rates were associated with higher categorical clinical improvement (aOR 4.30, P = 0.036 and aOR 7.36, P = 0.021, respectively) and decreased major amputation rates (aHR 0.11, P = 0.003 and aHR 0.09, P = 0.001, respectively) but were not related to multilevel TASC and Leriche-Fontaine classifications. Conclusions The present study reports a real-world experience with a large proportion of patients with chronic limb-threatening ischemia. Hybrid interventions for lower limb revascularization revealed to be a potential approach for patients with complex arterial disease that would beneficiate from less invasive procedures.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationAnn Vasc Surg. 2019 Oct;60:355-363pt_PT
dc.identifier.doi10.1016/j.avsg.2019.03.025pt_PT
dc.identifier.eissn1615-5947
dc.identifier.issn0890-5096
dc.identifier.urihttp://hdl.handle.net/10451/45361
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.relation.publisherversionhttps://www.annalsofvascularsurgery.com/pt_PT
dc.titleHybrid surgery in lower limb revascularization : a real-world experience from a single centerpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage363pt_PT
oaire.citation.startPage355pt_PT
oaire.citation.titleAnnals of Vascular Surgerypt_PT
oaire.citation.volume60pt_PT
person.familyNameSoares
person.familyNameGouveia e Melo
person.familyNameAlmeida Ministro
person.familyNameSobrinho
person.familyNameFernandes e Fernandes
person.familyNamePedro
person.givenNameTony
person.givenNameRyan
person.givenNameAugusto Manuel
person.givenNameGonçalo
person.givenNameRuy
person.givenNameLuís
person.identifier.ciencia-id211B-B548-CE4E
person.identifier.ciencia-id1F12-4544-1A00
person.identifier.ciencia-id3514-2431-1C78
person.identifier.ciencia-idB710-641D-77AD
person.identifier.ciencia-id0B14-1812-24DC
person.identifier.orcid0000-0002-9344-6858
person.identifier.orcid0000-0001-8327-6384
person.identifier.orcid0000-0003-4042-496X
person.identifier.orcid0000-0003-1050-4715
person.identifier.orcid0000-0003-1619-8851
person.identifier.orcid0000-0003-4310-9324
person.identifier.scopus-author-id8256157300
person.identifier.scopus-author-id39761284300
person.identifier.scopus-author-id7004454630
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication9b613757-407c-463f-ae2c-b649a3f2b6b2
relation.isAuthorOfPublication5b231766-381e-40e7-ad60-f2e414c2eb38
relation.isAuthorOfPublication6cd64629-69ea-4cf3-bb87-919df93d3df8
relation.isAuthorOfPublication59690318-8ed6-455f-a593-dab81a172444
relation.isAuthorOfPublication8b4cff45-1799-4e5c-9d7b-61405e351329
relation.isAuthorOfPublicationff4d548a-318e-4368-b735-e8b82e060dd3
relation.isAuthorOfPublication.latestForDiscovery59690318-8ed6-455f-a593-dab81a172444

Files

Original bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
Hybrid_surgery.pdf
Size:
988.91 KB
Format:
Adobe Portable Document Format
Download

Collections

FM - Artigos em Revistas Internacionais