The Comparative Analysis between Surgical Thrombectomy and Hybrid Treatment in Salvage Operation

Kang, Han Saem; Han, Kyu Dam; Choi, Eun Hye; Park, Young Sam; Seo, Yeon Ho; Kim, Cheol Seung

Abstract

PURPOSE
Salvage operation is performed to improve the functional deficit of vascular access. This study is planned to evaluate the utility of the hybrid surgery through a comparative analysis between the results of surgical thrombectomy and those of hybrid surgery, combining surgical methods and endovascular treatments.
METHODS
From January 2007 to December 2008, surgical thrombectomy had been done to 55 patients, whereas hybrid surgery had been done to 111 patients from January 2009 to December 2011. We have done a comparative analysis on the patency rate after the salvage operation for each group, retrospectively. Medical records were reviewed for patient information and radiographic data was used for checking the stenosis site in the hybrid surgery group.
RESULTS
There were no statistically significant differences between the two groups, including age, gender, diabetes status, hypertension, and vascular access site or type. The primary patency rate was significantly higher in arteriovenous fistulas (65%) compared with arteriovenous grafts group (55%), at 12 months (P<0.01). At one year after the salvage operation, the secondary patency rate was higher in the hybrid surgery group compared to the surgical thrombectomy group (43.8% vs. 23.7%, P<0.01).
CONCLUSION
This study shows that hybrid surgery combining surgical methods and endovascular treatments can be more useful for the salvaging of thrombosed vascular access than performing only surgical thrombectomy.