CASE REPORT


Endovascular Surgery or Both: A Case Report of Hybrid Procedure in a Patient with Abdominal Aortic Aneurysm and Tasc D Aortoiliac Occlusive Disease



Sidhi Laksono Purwowiyoto1, 2, *, R. Mohammad Reza Juniery Pasciolly3, Ananta Siddhi Prawara4
1 Department of Cardiology and Vascular Medicine, Head of Cardiac Catheterization Laboratory, RSUD Pasar Rebo, East Jakarta, Indonesia
2 Faculty of Medicine, Universitas Muhammadiyah Prof. DR. Hamka, Tangerang, Indonesia
3 Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Islam Bandung, RSUD Al Ihsan, Bandung, Indonesia
4 Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia


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© 2020 Purwowiyoto et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Faculty of Medicine, Universitas Muhammadiyah Prof. DR. Hamka, Tangerang, Indonesia; and Faculty of Medicine, Universitas Muhammadiyah Prof. DR. Hamka, Tangerang, Indonesia; Jl. Raden Patah No.01, RT.002/RW.006, Parung Serab, Kec. Ciledug, Kota Tangerang, Banten 13460, Indonesia; Tel: +628111585599; E-mail: sidhilaksono@uhamka.ac.id


Abstract

Hybrid procedure, a combination of endovascular and open surgical approach, has emerged as the first-line treatment for patients with severe aortoiliac diseases because of its effectiveness. We report a hybrid procedure in a 72 year old man with an Abdominal Aortic Aneurysm (AAA) and Trans-Atlantic Inter-Society Consensus (TASC) D aortoiliac occlusive disease. After two failed attempts using the intraluminal technique (retrograde and antegrade), we successfully performed an endovascular approach with subintimal and Subintimal Arterial Flossing Antegrade-retrograde Intervention (SAFARI) technique with the help of roadmap technology. The vascular surgeon completed the procedure by creating femorofemoral bypass using a Great Saphenous Vein (GSV) graft. The graft was patent and there were no complications at 1 week, 1 month and 6 months follow-up.

Keyword: Aortoiliac disease, Femorofemoral bypass graft, Hybrid procedure, Roadmap technology, SAFARI technique, Severe ischaemia.