Key result
Hybrid revascularisation alongside common femoral endarterectomy did not significantly increase the incidence of surgical site infection compared with endarterectomy alone (9% vs 6%; p=0.77).
Why the study?
A hybrid approach is increasingly used in peripheral arterial disease management, but its surgical site infection incidence compared with common femoral endarterectomy alone required assessment.
Does hybrid revascularisation alongside common femoral endarterectomy increase the incidence of surgical site infection compared to common femoral endarterectomy alone in patients with peripheral arterial disease?
Observational (n=155)
Does hybrid revascularisation alongside common femoral endarterectomy increase the incidence of surgical site infection compared to common femoral endarterectomy alone in patients with peripheral arterial disease?
Hybrid revascularisation alongside common femoral endarterectomy allows for single-stage treatment of multilevel peripheral arterial disease without significantly increasing the risk of surgical site infection compared to endarterectomy alone.
Hybrid revascularisation with CFEA was not associated with higher surgical site infection; hypothesis-generating for single-stage multilevel PAD treatment.
A hybrid approach is increasingly being employed in the management of peripheral arterial disease. This study aimed to assess the surgical site infection (SSI) incidence of hybrid revascularisation (HR) compared with common femoral endarterectomy (CFEA) alone. This was a retrospective review of consecutive patients who underwent CFEA or HR alongside CFEA between 2017 and 2021 including 1 year of follow up. The primary outcome was incidence of SSI. Secondary outcomes included length of surgery, duration of admission, further revascularisation surgery, limb salvage, and mortality. Differences in outcomes were assessed with the Student’s unpaired t-test, chi-square test, and Fisher’s exact test. A total of 157 groin incisions from 155 patients were included: 78 had CFEA procedures and 79 had HR procedures. No statistical difference was found between groups for age, sex, and indication for surgery. Surgical site infection occurred in five of the CFEA patients (6%) compared with seven of the HR patients (9%) (p = .77). The HR procedures took significantly longer, with an average of 299 minutes compared with 220 minutes for CFEA (p < .001). No statistically significant difference was identified for length of admission: median stay 5 days for CFEA vs. 4 days for HR (p = .44). Major amputation was performed within 1 year in five of the CFEA procedures (6%) and five of the HR procedures (6%) (p = 1.0). Further revascularisation surgery was attempted in two patients in the HR group and six patients in the CFEA group (p =. 17). No statistically significant difference was found in 1 year mortality: eight CFEA (10%) and seven HR (9%) (p = .77). Patients who underwent HR alongside CFEA did not have a statistically significantly increased incidence of SSI, despite increased surgical time. Utilising HR techniques enabled patients to have multilevel disease treated in one stage without an increased incidence of SSI.
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Walker et al. (2024) conducted an observational in Peripheral arterial disease (n=155). Hybrid revascularisation (HR) alongside common femoral endarterectomy (CFEA) vs. Common femoral endarterectomy (CFEA) alone was evaluated on Incidence of surgical site infection (SSI) (p=.77). Hybrid revascularisation alongside common femoral endarterectomy did not significantly increase the incidence of surgical site infection compared with endarterectomy alone (9% vs 6%; p=0.77).
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