Vol. 22 No. 4 (2018)
CASE REPORTS

A clinical case of hybrid treatment of a patient with multilevel arterial occlusive disease in lower limb arteries

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  • M. Chernyavskiy,
  • B. Artyushin,
  • A. Chernov,
  • D. Chernova,
  • N. Zherdev,
  • Yu. Kudaev,
  • I. Chuikova
M. Chernyavskiy
Almazov National Medical Research Centre, Ministry of Health of the Russian Federation, Saint Petersburg, Russian Federation
B. Artyushin
Almazov National Medical Research Centre, Ministry of Health of the Russian Federation, Saint Petersburg, Russian Federation
Bio
A. Chernov
Almazov National Medical Research Centre, Ministry of Health of the Russian Federation, Saint Petersburg, Russian Federation
D. Chernova
Almazov National Medical Research Centre, Ministry of Health of the Russian Federation, Saint Petersburg, Russian Federation
N. Zherdev
Almazov National Medical Research Centre, Ministry of Health of the Russian Federation, Saint Petersburg, Russian Federation
Yu. Kudaev
Almazov National Medical Research Centre, Ministry of Health of the Russian Federation, Saint Petersburg, Russian Federation
I. Chuikova
Almazov National Medical Research Centre, Ministry of Health of the Russian Federation, Saint Petersburg, Russian Federation
DOI: https://doi.org/10.21688/1681-3472-2018-4-103-110

Published 2018-12-29

Keywords

  • atherosclerosis,
  • critical limb ischemia,
  • hybrid surgical procedures

How to Cite

Chernyavskiy, M., Artyushin, B., Chernov, A., Chernova, D., Zherdev, N., Kudaev, Y., & Chuikova, I. (2018). A clinical case of hybrid treatment of a patient with multilevel arterial occlusive disease in lower limb arteries. Patologiya Krovoobrashcheniya I Kardiokhirurgiya, 22(4), 103–110. https://doi.org/10.21688/1681-3472-2018-4-103-110

Copyright (c) 2018 Chernyavskiy M. A., Artyushin B. S., Chernov A. V., Chernova D. V., Zherdev N. N., Kudaev Yu. A., Chuikova I. O.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

Treatment of patients with multilevel arterial occlusive disease in lower limb arteries is one of the challenges in vascular surgery. The need in blood flow restoration in several arterial segments usually leads to the problem of choosing a surgical procedure. Open surgery of several arterial segments is linked with a high risk of intraoperative complications, while endovascular procedures are not always possible, especially with long lesions. In such cases, hybrid surgery turns out to be a method of choice. We report the case of 50-year old patient with complaints of the right lower limb pain at rest, trophic ulcers in the right foot. The medical record showed 5-year claudification, with a gradual decrease in painless walking distance. In 2017, he underwent right common iliac artery stenting without a positive effect. Upon admission, occlusion of the right external iliac artery and superficial femoral artery was identified. After additional examination, crossing of lesions, balloon angioplasty and stenting of aorto-iliac and femoral-popliteal segments were successfully performed. The presented clinical case demonstrates high effectiveness in combination of open and endovascular procedures, while treating multilevel arterial occlusive disease. Hybrid surgical procedures allow to reduce traumatism, risk of postoperative complications and length of in-hospital stay. The main advantages and disadvantages of current surgical methods for treatment of multilevel aorto-iliac-femoral lesions are discussed. Performing hybrid surgical procedures is possible only with an experienced vascular team and in specialized hybrid operating room.

Received 3 August 2018. Revised 26 November 2018. Accepted 30 November 2018.

Informed consent: The patient’s informed consent to use his records for medical purposes is obtained.

Funding: The study did not have sponsorship.

Conflict of interest: Authors declare no conflict of interest.

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