Crystal M. Kavanagh, MD, Michael J. Heidenreich, MD, Jeremy J

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Presentation transcript:

Hybrid external iliac selective endarterectomy surgical technique and outcomes Crystal M. Kavanagh, MD, Michael J. Heidenreich, MD, Jeremy J. Albright, PhD, Abdulhameed Aziz, MD Journal of Vascular Surgery Volume 64, Issue 5, Pages 1327-1334 (November 2016) DOI: 10.1016/j.jvs.2016.03.468 Copyright © 2016 Society for Vascular Surgery Terms and Conditions

Fig 1 A, Intraluminal access is first achieved through insertion of micropuncture needle and wire (black arrow). B, Angiography with demonstration of long, multisegmental external iliac disease. C, Various sized mollrings. D, Retrograde, overwire (black arrow) advancement of the mollring (white arrow), around the distally endarterectomized and transected plaque. E, Fluoroscopic image of correctly positioned mollring, just distal to the iliac bifurcation. F, Inflation of a 7-mm × 2-cm angioplasty balloon to burst pressure to create an intraluminal transection point. G, Plaque being extracted over wire. H, Angiographic run after plaque extraction with evidence of a dissection flap at the proximal transection point. I, Widely patent vessel after external iliac artery (EIA) stent placement. J, Distal vessel lumen before closure with bovine pericardial patch. K, Final plaque length in this case measured 13 cm. Journal of Vascular Surgery 2016 64, 1327-1334DOI: (10.1016/j.jvs.2016.03.468) Copyright © 2016 Society for Vascular Surgery Terms and Conditions

Fig 2 Characteristics of treated patients. Numbers proceeding v on the x-axis in infrageniculate disease category refer to number of vessels providing runoff. fem/pop, Femoral/popliteal; Hypo, hypogastric; Pre-op, preoperative; PTA, percutaneous transluminal angioplasty; TASC II, TransAtlantic Inter-Society Consensus II. Journal of Vascular Surgery 2016 64, 1327-1334DOI: (10.1016/j.jvs.2016.03.468) Copyright © 2016 Society for Vascular Surgery Terms and Conditions

Fig 3 Preoperative and postoperative objective comparison. ABI, Ankle-brachial index; TP, toe pressure. Journal of Vascular Surgery 2016 64, 1327-1334DOI: (10.1016/j.jvs.2016.03.468) Copyright © 2016 Society for Vascular Surgery Terms and Conditions

Fig 4 Survival curve for time in days since the procedure. The crosses represent censoring, or the last time the patient was observed in the facility. There were only two failures. These occurred for both limbs of the same patient 655 days out from the procedure. No other failures were observed. Journal of Vascular Surgery 2016 64, 1327-1334DOI: (10.1016/j.jvs.2016.03.468) Copyright © 2016 Society for Vascular Surgery Terms and Conditions