Abstract
Hybrid procedure, a combination of endovascular and open surgical approach, has emerged as the first-line treatment for patients with severe aortoiliac diseases because of its effectiveness. We report a hybrid procedure in a 72 year old man with an Abdominal Aortic Aneurysm (AAA) and Trans-Atlantic Inter-Society Consensus (TASC) D aortoiliac occlusive disease. After two failed attempts using the intraluminal technique (retrograde and antegrade), we successfully performed an endovascular approach with subintimal and Subintimal Arterial Flossing Antegrade-retrograde Intervention (SAFARI) technique with the help of roadmap technology. The vascular surgeon completed the procedure by creating femorofemoral bypass using a Great Saphenous Vein (GSV) graft. The graft was patent and there were no complications at 1 week, 1 month and 6 months follow-up.
Highlights
The Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL) trial answered the debate regarding the best treatment for the aortoiliac disease [1]
We report a case of a 72-year-old male with an Abdominal Aortic Aneurysm (AAA) and Trans-Atlantic Inter-Society Consensus (TASC) D aortoiliac occlusive disease who successfully underwent a hybrid procedure
The changes in serum creatinine was a contrast-induced acute kidney injury (CI-AKI) due to the contrast (200 mL Iopamirol) that we administered during the intervention procedure
Summary
The Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL) trial answered the debate regarding the best treatment for the aortoiliac disease [1]. Both endovascular and open surgical approaches had similar outcomes in terms of amputation-free survival but the endovascular approach was superior because, in the short term, the surgical approach was more expensive [1]. Not all aortoiliac disease can be treated with the endovascular or open surgical approach alone. We report a case of a 72-year-old male with an Abdominal Aortic Aneurysm (AAA) and Trans-Atlantic Inter-Society Consensus (TASC) D aortoiliac occlusive disease who successfully underwent a hybrid procedure
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