The Role of Hybrid Revascularization Procedures for Symptomatic Chronic Peripheral Arterial Disease

Abstract Background Peripheral arterial disease (PAD) is a chronic vascular disease characterized by impaired circulation to the lower extremities. While early stages of PAD may be asymptomatic, the hallmarks of its most severe stage, known as chronic limb threatening ischemia (CLTI). It is a clinical syndrome defined by the presence of peripheral artery disease (PAD) in combination with rest pain, gangrene, or a lower limb ulceration >2 weeks duration. Aim of the Work The aim of this study is to assess the clinical and hemodynamic outcome of CLTI treated by hybrid revascularization procedures and the possible risk of postoperative amputation. Patients and Methods The following electronic databases were searched up to 2022: PubMed, Google Scholar search engine, Cochrane database of systematic reviews, EMBASE, Science Direct, Wiley Online Library, ELSEVIER, Scopus and the European journal of vascular society searching keywords and terms listed below: “Critical limb threatening ischemia, management of peripheral arterial disease, multi-level occlusive arterial disease, hybrid revascularization, outcome of hybrid procedures”. Results In our meta-analysis, risk factors of PAD included gender, smoking, HTN, DM, coronary artery disease, CVS, CKD, Hyperlipidemia and COPD. Success rate of hybrid revascularization technique showed a significant effect than other techniques. Conclusion The results of this meta-analysis showed that Diabetes Mellitus and hypertension are two major risk factors that worsen the outcome of hybrid procedures. Hybrid procedures have added to the armamentarium for treatment of patients with multilevel arterial disease and offer a less risky option for elderly patients with multiple comorbid conditions. Hybrid procedures are effective to treat patients with either CLI or claudication.