Endovascular stenting combined with conventional surgery for treatment of lower extremity multilevel atherosclerotic occlusive disease

Objective To study the treatment of multilevel atherosclerotic occlusive disease of the lower(extremity).Methods From March 2004 to January 2006,intraoperative iliac balloon angioplasty and stenting combined with simultaneous vascular bypass and profundoplasty were performed on 24 limbs in 21 patients(suffering) from lower extremity multilevel atherosclerotic occlusive disease.In 24 limbs iliac balloon angioplasty and stent placement were performed with simultaneous profundoplasty in 12 limbs and femoro-popliteal bypass in 14 limbs.Results Surgical procedures were technically successful in all patients.There were no severe postoperative morbidity or mortality.Before-operative vs postoperative ABI was 0.24±0.13 vs 0.63±(0.18)(P0.05).The mean following-up period was 13 months(range of 1 to 23 months).Follow-up observations found that none of the patients had rest pain,but four patients had intermittent claudication,3 of them received autologous bone stem cell transplantation 3 months after the operation and the claudication markedly improved.Conclusions Simultaneous intravascular interventional therapy combined with vascular(bypass) and profundoplasty are effective in the treatment of patients with severe and multilevel atherosclerotic(occlusive) diseasis of the lower extremity.The operation is less traumatic and the procedures are easy to do.The operative method is flexible and is especially suitable for high risk patients.