Vascupedia @ PVI 2023 | Open surgery for peripheral occlusive disease: How to do it?

Title: Hybrid treatment in patients with Critical Limb Ischemia

Speaker: Konstantinos Stavroulakis, MD


    Very nice presentation, indeed showing that the classic TASC-decision making era is outdated, since the TASC not-incorporated modern hybrid approach dictates endo-first, leaving for complementary open approach what cannot be endo-fixed!
    I’d like to ask whether you use a special re-entry device such as an Outback catheter to entry the true lumen from the subintimal space. Also, when to use simple stents or covered stents? According to my personal experience, when you treat with simple-stents (i.e, self-expandable) lesions which are proven thrombotic rather than atherosclerotic, the immediate or direct thrombotic effect is very likely; in that case, i’d use covered-stents. The same may apply for heavily calcified iliac lesions (such as the one presented and debated in the approx. 6th minute of the presentation), where inflating and covering with a bare stent may lead inadvertently to rupture.
    Once again, thank you for sharing the presentation.

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