Hybrid Common Femoral Vein Endophlebectomy and Iliac Vein Stenting Versus Femoro-Femoral Venous Bypass for Management of Chronic Iliofemoral Venous Occlusion

Both CFV endophlebectomy with iliac vein stenting and femoro-femoral venous bypass were feasible, safe, and effective treatment strategies for chronic iliofemoral venous occlusion with compromised venous inflow. Hybrid reconstruction represented a less invasive strategy, as reflected by shorter operative time and reduced hospital stay. This approach was associated with greater improvement in clinical outcome scores and preserved the feasibility of endovascular reintervention.Clinical ImpactBoth hybrid reconstruction and femoro-femoral venous bypass are associated with meaningful improvements in quality-of-life measures in selected patients with chronic iliofemoral venous obstruction and compromised venous inflow. Although improvements across clinical and patient-reported outcome scores were greater following the hybrid approach, femoro-femoral cross-over bypass remains a valuable bailout technique in cases where endovascular or hybrid intervention fails or is not possible.