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Hybrid revascularization

Giulio Illuminati, Giulia Pizzardi, Rocco Pasqua, Francesca Frezzotti, Piergaspare Palumbo, Francesco Macrina, Francesco Calio
BACKGROUND: Tandem stenoses of the internal carotid artery (ICA) and proximal, ipsilateral common carotid artery (CCA) or innominate artery can be treated with a hybrid approach, combining conventional carotid endarterectomy (CEA) and retrograde stenting of the proximal stenosis, through surgical exposure of the carotid bifurcation. The purpose of this study was to evaluate the results of combining eversion CEA with retrograde CCA/innominate artery stenting. MATERIAL AND METHODS: From January 2015 to July 2017, 7 patients, 6 men of a mean age of 72 years (range 59-83 years) underwent simultaneous, retrograde stenting of the proximal CCA/innominate artery and an eversion CEA of the ipsilateral ICA, through surgical exposure of the carotid bifurcation, for severe tandem stenoses...
March 10, 2018: International Journal of Surgery
Rocco A Montone, Giampaolo Niccoli
Patients with left main or multivessel coronary artery disease (CAD) and depressed left ventricular function undergoing coronary artery by-pass grafting (CABG) have a markedly worse prognosis compared with general population, making surgical treatment of CAD unattractive especially when features such as poor distal targets, severe comorbidities, reoperation, advanced age, or impaired renal function are present. At the same time, evidence for improved clinical outcome in this high-risk subset of patients using mini-invasive surgical techniques (i...
March 8, 2018: Minerva Cardioangiologica
Frank M Davis, Jeremy Albright, Katherine A Gallagher, Hitinder S Gurm, Gerald C Koenig, Theodore Schreiber, P Michael Grossman, Peter K Henke
OBJECTIVES: Acute limb ischemia (ALI) of the lower extremity is a potentially devastating condition that requires urgent and definitive management. This challenging scenario is often treated with endovascular, open surgical, or hybrid revascularization in an urgent basis, but the comparative effects of such therapies remain poorly defined. The purpose of this study was to compare outcomes of endovascular, open surgical, and hybrid revascularization for ALI in the contemporary era. METHODS: A large statewide cardiovascular consortium of 45 hospitals was queried for patients between January 2012 and June 2015 who underwent an endovascular, open surgical, or hybrid revascularization for ALI deemed at high risk of limb loss if not treated within 24 hours (Rutherford class IIA or IIB)...
March 5, 2018: Annals of Vascular Surgery
Alberto Repossini, Lorenzo Di Bacco, Fabrizio Rosati, Maurizio Tespili, Antonio Saino, Alfonso Ielasi, Claudio Muneretto
AIMS: Hybrid revascularization (HCR) has been recently proposed as an alternative strategy in multivessel coronary disease, particularly in patients with high SYNTAX scores and risk scores. The objective of this study is to evaluate the outcomes of HCR versus percutaneous coronary intervention (PCI) drug-eluting stenting in left main treatment. METHODS: A series of 198 consecutive patients with left main stenosis have been treated. HCR, was performed in 77 patients (G1) whereas 121 patients (G2) received PCI on left main...
March 6, 2018: Journal of Cardiovascular Medicine
Romeo Martini
In this review 14 studies were identified reporting the treatment strategy in 4891 patients with Critical Limb Ischemia (CLI) with the aim to investigate if the strategy of treatment of the first episode of CLI has changed during the last 15-20 years. A computer research has been performed on PubMed and Scopus databases on November 2016. The used terms for the investigation about studies evaluating the strategy of treatment of CLI at the first-time presentation, have been "critical leg ischemia", "critical limb ischemia", "critical lower limb ischemia" along with the terms "placebo", "medical treatment" and/or "conservative" revascularisation, surgical revascularisation, endovascular revascularisation, hybrid revascularisation and primary amputation...
March 1, 2018: Clinical Hemorheology and Microcirculation
Nikolas Tsilimparis, Sebastian E Debus, Max Biehl, Konstantinos Spanos, Axel Larena-Avellaneda, Sabine Wipper, Fiona Rohlffs, Tilo Kölbel
OBJECTIVE: The aim of this study was to assess the immediate postoperative and midterm outcome of complex aortic aneurysm treatment necessitating four-vessel revascularization with either a total endovascular approach (fenestrated-branched stent graft [FBSG]) or a hybrid technique of visceral debranching plus stenting. METHODS: The clinical data of consecutively treated patients presenting with a complex aortic aneurysm that necessitated four-vessel revascularization between 2010 and 2015 were retrospectively analyzed...
March 1, 2018: Journal of Vascular Surgery
L Fidalgo Domingos, E M San Norberto García, D Gutiérrez Castillo, C Flota Ruiz, I Estévez Fernández, C Vaquero Puerta
BACKGROUND: Endovascular procedures come with a potential risk of radiation hazards both to patients and to the vascular staff. Classically, most endovascular interventions took place in regular operating rooms using a fluoroscopy C-arm unit controlled by a third party. Hybrid operating rooms (HOR) provide an optimal surgical suit with all the qualities of a fixed C-arm device, while allowing the device to be controlled by the surgical team. The latest studies suggest that an operator-controlled system may reduce the radiation dose...
February 28, 2018: Annals of Vascular Surgery
Benedikt Mayr, Christian Firschke, Magdalena Erlebach, Sabine Bleiziffer, Markus Krane, Michael Joner, Ulf Herold, Christian Nöbauer, Rüdiger Lange, Marcus-André Deutsch
OBJECTIVES: Simultaneous surgical off-pump coronary revascularization and transcatheter aortic valve implantation (TAVI) as a hybrid procedure may be a therapeutic option for patients with a TAVI indication who are not suitable for percutaneous coronary intervention and for patients who have an indication for combined surgical aortic valve implantation and coronary artery bypass grafting but present with a porcelain aorta. Early outcomes of these patients are analysed in this study. METHODS: From February 2011 to April 2017, hybrid TAVI/off-pump coronary artery bypass (OPCAB) was performed in 12 (60%) patients, hybrid TAVI/minimally invasive direct coronary artery bypass in 6 (30%) patients and staged TAVI/OPCAB in 2 (10%) patients...
February 26, 2018: Interactive Cardiovascular and Thoracic Surgery
Toshio Takayama, Jon S Matsumura
BACKGROUND: Complete revascularization, achieving inline flow to the foot through at least 1 patent tibioperoneal artery, is considered to be desirable for treating critical limb ischemia (CLI). Hybrid procedure, combined femoral endarterectomy and endovascular treatment, is commonly performed on patients with CLI because they often present with complicated lower extremity lesions involving the common femoral artery. This study aimed to investigate the efficacy of complete revascularization (CR) achieved by hybrid procedure on limb salvage in patients with CLI...
January 1, 2018: Vascular and Endovascular Surgery
Soon Cheon Lee, Jin Hyun Joh, Jeong-Hwan Chang, Hyung-Kee Kim, Jang Yong Kim, KiHyuk Park, Ki Chun Hong, Seung Jae Byun, Tae Seung Lee, Hyuk Jae Jung, Sang Su Lee
BACKGROUND: Endovascular treatment is an alternative first-line management for peripheral artery disease (PAD). Hybrid treatment (HT) is defined as a combined treatment for patients with PAD using endovascular and open surgery, simultaneously performed in an operating room. The results of HT are reportedly good for multilevel revascularization (MR) in patients with chronic limb ischaemia, and even in older high-risk patients. The goal of this study was to examine the clinical and haemodynamic outcomes of HT in patients who need MR...
February 27, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Juliet J Ray, Sarah A Eidelson, Charles A Karcutskie, Jonathan P Meizoso, Hilene DeAmorim, Lee J Goldstein, John Karwowski, Arash Bornak
INTRODUCTION: This study examines the outcome of hybrid revascularization combining iliofemoral endartectomy and iliac artery stenting using covered stents in TASC C and D aortoiliac occlusive disease (AIOD) involving the common femoral artery (CFA). METHODS: A retrospective review was conducted of patients with TASC C and D AIOD involving the CFA and undergoing hybrid revascularization. Covered stents were used primarily. Demographics, indications for surgery, lesion classification, hospital length-of-stay (LOS), 30-day morbidity/mortality, hemodynamic and clinical success, as well as patency were assessed...
February 23, 2018: Annals of Vascular Surgery
Shakil Farid, Jason M Ali, Victoria Stohlner, Ruhina Alam, Peter Schofield, Samer Nashef, Ravi De Silva
OBJECTIVE: The primary objective was to investigate the long-term survival of patients who underwent single-vessel coronary revascularization with minimally invasive direct coronary artery bypass surgery with or without hybrid revascularization. The secondary outcome measures were repeat revascularization either by coronary artery bypass grafting or by percutaneous coronary intervention and the incidence of myocardial infarction or recurrent angina. METHODS: This is a retrospective study of prospectively collected data of patients who underwent minimally invasive direct coronary artery bypass procedure in our center between January 2001 and December 2015...
January 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Patrícia Feitosa Frota Dos Reis, Pedro Vieira Linhares, Fábio Grunspun Pitta, Eduardo Gomes Lima
The concomitance between coronary artery disease and carotid artery disease is known and well documented. However, it is a fact that, despite the screening methods for these conditions and the advances in surgical treatment, little has been achieved in terms of reducing the risk of complications in the perioperative period. Publications are scarce, being mostly composed of reports or case series. There is little agreement on the best initial therapeutic approach (myocardial versus carotid revascularization) or the best technique to be used (surgery with or without extracorporeal circulation, hybrid treatments, etc...
November 2017: Revista da Associação Médica Brasileira
Christian Uhl, Thomas Betz, Barbara Weiss, Ingolf Töpel, Markus Steinbauer
INTRODUCTION: According to the guidelines aortoiliac TASC D lesions should be treated by bypass. The purpose of this study was to examine the results of hybrid procedures with the use of a self-expanding covered heparin-bonded stent graft (Viabahn) in patients with extensive aorto-iliac lesions who were not considered to be suitable for open aorto-iliac surgery. METHODS: All patients who received a hybrid procedure in combination with a Viabahn stent in our clinic to treat aortoiliac lesions between October 2011 and April 2017 were included in this retrospective analysis...
February 8, 2018: Journal of Cardiovascular Surgery
Naoki Misumida, David J Moliterno
The present meta-analysis found no significant difference between hybrid coronary revascularization (HCR) and bypass surgery (CABG) regarding intermediate-term major adverse cardiac and cerebrovascular events. HCR is feasible, historically with higher revascularization rates but less perioperative morbidity With a comparable frequency of repeat revascularization between current-generation drug-eluting stents and CABG, future trials of HCR are considering multi-vessel PCI as the new comparator.
February 1, 2018: Catheterization and Cardiovascular Interventions
Lorenzo Azzalini, Soledad Ojeda, Aris Karatasakis, Joren Maeremans, Masaki Tanabe, Alessio La Manna, Rustem Dautov, Luiz F Ybarra, Susanna Benincasa, Barbara Bellini, Luciano Candilio, Ozan M Demir, Francisco Hidalgo, Judit Karacsonyi, Giacomo Gravina, Eligio Miccichè, Guido D'Agosta, Giuseppe Venuti, Corrado Tamburino, Manuel Pan, Mauro Carlino, Joseph Dens, Emmanouil S Brilakis, Antonio Colombo, Stéphane Rinfret
BACKGROUND: We aimed to investigate the procedural and long-term outcomes of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) in patients who had undergone previous coronary artery bypass grafting (CABG) vs those who had not, and to evaluate the role of the Registry of CrossBoss and Hybrid procedures in France, the Netherlands, Belgium, and United Kingdom (RECHARGE) score in predicting acute and long-term outcomes. METHODS: We compiled a multicentre registry of consecutive patients undergoing CTO PCI at 7 centres between January 2009 and April 2017...
December 26, 2017: Canadian Journal of Cardiology
Carlota Fernandez Prendes, Carol Padrón Encalada, Ahmad Amer Zanabili Al-Sibbai, Jose Antonio Del Castro Madrazo, Lino Antonio Camblor Santervas, Manuel Alonso Perez
PURPOSE: To describe the uses and advantages of hybrid vascular grafts (HVGs) for complex iliofemoral revascularization procedures. CASE REPORT: We report 3 cases of iliofemoral occlusions repaired with the Gore HVG, used as an alternative technique to standardized common femoral artery (CFA) endarterectomy associated with iliac stenting or open repair. The indication in each of the 3 cases was different: In the first case, there was an absent CFA secondary to a mycotic pseudoaneurysm, in the second case, an iatrogenic lesion of the posterior wall of the CFA during the intervention was performed, and in the third case, the indication was because of thrombosis of a previous iliofemoral revascularization procedure...
January 1, 2018: Vascular and Endovascular Surgery
Eduardo Keller Saadi, Gustavo Oderich, Eduardo Medronha, Rodrigo Petersen Saadi, Marina Petersen Saadi, Cristiano Jaegger
Symptomatic occlusion of the superior mesenteric artery can be treated by open repair, hybrid procedure, or endovascular revascularization. In most cases, endovascular procedures are done by the antegrade approach. We report a case of a 67-year-old woman who presented with acute-on-chronic mesenteric ischemia successfully treated by retrograde endovascular recanalization of an occluded common hepatomesenteric trunk through the inferior mesenteric artery and arc of Riolan.
September 2017: Journal of Vascular Surgery Cases and Innovative Techniques
Joost A Bekken, Sanne W de Boer, Rogier van der Sluijs, Hidde Jongsma, Jean-Paul P M de Vries, Bram Fioole
PURPOSE: To evaluate the long-term results of remote iliac artery endarterectomy (RIAE) in 2 vascular referral centers and review existing literature. METHODS: A retrospective analysis was conducted of 109 consecutive patients (mean age 64.2±10.7 years; 72 men) who underwent 113 RIAE procedures for lower limb ischemia from January 2004 to August 2015 at 2 vascular centers. The majority of limbs (82, 72.6%) had TASC II D lesions (31 TASC II C). Primary outcome measures were primary, assisted primary, and secondary patency...
February 2018: Journal of Endovascular Therapy
Joanna Foik, Anna Brzęk, Marek J Gierlotka, Michał O Zembala, Mariusz Gąsior, Marian Zembala
INTRODUCTION    Rehabilitation after coronary revascularization procedures is an intrinsic element of treatment during the in-hospital period. OBJECTIVES    The aim of this study was to compare the course and effects of rehabilitation in patients receiving hybrid or classical treatment during the in-hospital period. PATIENTS AND METHODS    Two hundred patients participating in a prospective, random-ized clinical trial (POLMIDES), that assessed the effect of hybrid treatment on in-hospital outcomes and remote results in patients with multi-vessel coronary artery disease were ana-lysed...
January 2, 2018: Polish Archives of Internal Medicine
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