Frontiers in Surgery最新文献

{"title":"Meta-analysis of risk factors for postoperative lower extremity deep vein thrombosis in patients with gynecologic malignancies.","authors":"Danzhu Gong, Qi Wang","doi":"10.3389/fsurg.2025.1406425","DOIUrl":"10.3389/fsurg.2025.1406425","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to elucidate the risk factors associated with postoperative lower extremity deep vein thrombosis (DVT) in patients afflicted with gynecologic malignancies.</p><p><strong>Methods: </strong>A comprehensive search was conducted across CNKI, CQVIP, Wanfang, and PubMed databases for literature published from January 1, 2024, concerning the risk factors for postoperative DVT in patients with gynecologic cancers. Two researchers independently and objectively screened, extracted, and evaluated the pertinent data. Subsequently, the extracted data were subjected to meta-analysis using STATA software.</p><p><strong>Results: </strong>A total of twelve studies fulfilling the inclusion criteria were analyzed, encompassing 2,553 cases. The meta-analysis revealed that significant risk factors for postoperative lower extremity DVT in patients with gynecologic malignancies include age [Odds Ratio (OR) = 1.35, 95% Confidence Interval (CI) (1.19, 1.54), <i>P</i> < 0.001], Body Mass Index (BMI) [OR = 1.67, 95% CI (1.05, 2.66), <i>P</i> < 0.001], plasma D-dimer levels [OR = 3.39, 95% CI (1.24, 9.24), <i>P</i> < 0.001], duration of surgery [OR = 2.24, 95% CI (1.24, 4.01), <i>P</i> < 0.001], and duration of postoperative bed rest [OR = 2.14, 95% CI (1.56, 2.94), <i>P</i> < 0.001].</p><p><strong>Discussion: </strong>The study identifies multiple risk factors influencing the incidence of postoperative lower extremity DVT in patients with gynecologic malignancies. Notably, age, BMI, plasma D-dimer levels, surgical duration, and postoperative bed rest emerge as significant predictors. These findings underscore the necessity for targeted prophylaxis and therapeutic interventions in the clinical management of such patients.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1406425"},"PeriodicalIF":1.6,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11798952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indocyanine green fluorescence improves safety in laparoscopic cholecystectomy using the Fundus First technique: a retrospective study.","authors":"Susanna Haverinen, Evelina Pajus, Gabriel Sandblom, Yücel Cengiz","doi":"10.3389/fsurg.2025.1516709","DOIUrl":"10.3389/fsurg.2025.1516709","url":null,"abstract":"<p><strong>Introduction: </strong>As one of the most commonly performed surgeries in the world, safety during laparoscopic cholecystectomy (LC) is of utmost importance. Indocyanine green (ICG) has been used for different medical purposes including assessment of liver function since the 1950s. Its use during LC was first described in 2009 by Ishizawa. Since ICG is excreted in the bile, its fluorescent properties can be used to illuminate the bile ducts, and may reduce the risk for bile duct injury and other complications. Previous studies have compared ICG with conventional visualization showing shorter operation time and lower conversion rates during LC performed with traditional operation techniques. Results from LC performed with the Fundus First method (FF-LC) and ICG fluorescence has not been previously reported. The aim of this retrospective study was to compare LC with and without the aid of ICG fluorescence at a Swedish hospital routinely performing FF-LC.</p><p><strong>Methods: </strong>Data from all patients operated with LC at Sundsvall General Hospital before and after the implementation of routine ICG between 2016 and 2023 were analyzed.</p><p><strong>Results: </strong>The study included 2,009 patients; 1,455 operated with ICG (ICG-group) and 549 without (comparison group). FF-LC was used in 94.9% of all operations. The groups were comparable regarding gender, BMI, age, presence of acute cholecystitis and proportion urgent/elective surgery. ICG was found to be safe, with similar 30-day complication rates between study groups. A lower conversion rate was seen in the ICG-group (1.2% vs. 3.3%, <i>p</i> = 0.001) and there was a non-significant reduction in readmissions (<i>p</i> = 0.054). In univariate analysis, ICG was associated with prolonged operation time, but this was not supported in multivariate analysis. Time to cholangiography was prolonged in the ICG-group in both univariate and multivariate analyses.</p><p><strong>Discussion: </strong>ICG fluorescence is an adjunct that could improve the operative safety. Implementation of routine ICG fluorescence at this Swedish hospital was found to be safe and efficient, suggesting improvement in safety during FF-LC. Further studies are needed to see if ICG increases safety in LC.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1516709"},"PeriodicalIF":1.6,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11798932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidural abscess formation after chemotherapy for breast cancer: a case report and literature review.","authors":"Youzhi An, Lili Li, Qingning Liu, Zhen Zhang, Xuelin Lin","doi":"10.3389/fsurg.2025.1388278","DOIUrl":"10.3389/fsurg.2025.1388278","url":null,"abstract":"<p><strong>Introduction: </strong>Spinal epidural abscess is a rare infectious lesion of the central nervous system. Here, we report a rare case of a thoracic suppurative epidural abscess in a female patient who developed incomplete paralysis of both lower limbs after chemotherapy for breast cancer. She underwent surgery and recovered well after surgery.</p><p><strong>Case report: </strong>A 49-year-old female patient developed an epidural abscess after chemotherapy for breast cancer; she suffered sudden pain and paralysis in both lower limbs. Thoracic T9-T11 laminectomy, abscess removal, bone grafting, fusion, and internal fixation were performed. After the operation, the muscle strength in both lower limbs gradually recovered.</p><p><strong>Discussion: </strong>This is the first reported case of an epidural abscess after chemotherapy for breast cancer. The disease progresses rapidly. During the literature review process, we found that timely removal of the epidural abscess, combined with the administration of appropriate antibiotics at the same time, is crucial for improved healing and successful treatment.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1388278"},"PeriodicalIF":1.6,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11798992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of clinical efficacy of unilateral biportal endoscopic and open transforaminal lumbar interbody fusion in the treatment of lumbar degenerative.","authors":"Tao Ma, Xiaoshuang Tu, Junyang Li, Yongcun Geng, Jingwei Wu, Senlin Chen, Dengming Yan, Ming Jiang, Gongming Gao, Luming Nong","doi":"10.3389/fsurg.2025.1487168","DOIUrl":"10.3389/fsurg.2025.1487168","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To study the clinical efficacy of unilateral biportal endoscopic lumbar interbody fusion (ULIF) and transforaminal lumbar interbody fusion (TLIF) in the treatment of lumbar degenerative diseases, and to compare perioperative indicators, radiological outcomes, and paraspinal muscle -atrophy resulting from these two different surgical methods.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Transforaminal lumbar interbody fusion (TLIF) is widely acknowledged as an efficacious surgical modality for alleviating low back pain. In recent years, unilateral biportal endoscopic lumbar interbody fusion (ULIF) has gained increasing application.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We recorded the basic information of patients who underwent single-segment ULIF or TLIF for the first time in our hospital from May 2021 to November 2022, including age, gender, BMI, diagnosis, and surgical segment. Perioperative indicators such as estimated blood loss, operation time, postoperative hospital stay, and complications were observed in both groups. Clinical efficacy was assessed preoperatively and at 1 month, 3 months, and 12 months postoperatively using the Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI). Patient satisfaction was evaluated using the modified Macnab criteria. The displacement of the fusion device was also assessed. x-rays were taken preoperatively, at 3 months postoperatively, and at 12 months postoperatively to observe fusion device displacement and measure the intervertebral disc height of the upper and lower segments. The Cobb angle was used to measure lumbar lordosis and segmental lumbar lordosis. CT scans at 3 months postoperatively were used to observe intervertebral fusion, including bridging trabeculae, endplate cysts, and screw loosening. MRI at 1 year postoperatively was used to manually trace the cross-sectional area of the paraspinal muscles to compare muscle atrophy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 150 patients were included in the study, with 71 patients in the ULIF group and 79 patients in the TLIF group. No statistically significant disparities were observed between the two groups with respect to age, gender, BMI, diagnosis, and surgical segment&lt;b&gt;.&lt;/b&gt; The estimated blood loss in the ULIF group was 108.78 ± 58.3 ml, which was significantly less than that in the TLIF group at 199.44 ± 84.91 ml (&lt;i&gt;p&lt;/i&gt; &lt; 0.001). The postoperative hospital stay was shorter in the ULIF group (&lt;i&gt;p&lt;/i&gt; = 0.020), although the operation time was longer for ULIF. There were no significant differences in complications between the two groups. Patients in the ULIF group experienced quicker relief from back pain postoperatively, but there were no significant differences between the ULIF and TLIF groups in the VAS, ODI, and satisfaction rates at the final follow-up. At 3 months postoperatively, the ULIF group demonstrated a higher incidence of bridging trabeculae, a lower incidence of endplate cysts, and less fusion de","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1487168"},"PeriodicalIF":1.6,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11798791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Surgical treatment of thymic epithelial tumor and myasthenia gravis.","authors":"Piergiorgio Muriana","doi":"10.3389/fsurg.2025.1553723","DOIUrl":"10.3389/fsurg.2025.1553723","url":null,"abstract":"","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1553723"},"PeriodicalIF":1.6,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11798965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accidental intra-arterial injection of enoxaparin sodium leading to abdominal wall expanding subcutaneous hematoma and abdominal wound: case report-vascular.","authors":"Caroline Howell, Richard Simman","doi":"10.3389/fsurg.2025.1477926","DOIUrl":"10.3389/fsurg.2025.1477926","url":null,"abstract":"<p><strong>Introduction: </strong>Enoxaparin sodium (Lovenox®) is a commonly used anticoagulant medication that is self-administered via subcutaneous injection to prevent the formation of pathologic blood clots. It is used as a bridge to long-term anticoagulation with warfarin in patients at high risk for thromboembolic events. It is generally well-tolerated and has a favorable safety profile. The most common injection site reactions caused by enoxaparin sodium are urticaria, ecchymosis, and skin and fat necrosis.</p><p><strong>Case report: </strong>A 56 year-old female with extensive thromboembolic history was completing an enoxaparin sodium bridge to warfarin when she accidentally self-injected enoxaparin sodium into the left superficial epigastric artery, resulting in the formation of a large expanding hematoma and the development of hemorrhagic shock. Controlling the bleeding required reversal of anticoagulation, transfusion, and coil embolization of the affected arteries. Surgical evacuation of the hematoma was performed, and the resultant wound was managed postoperatively with negative pressure wound therapy (NPWT) for one month. After discontinuation of NPWT, the wound was allowed to heal by secondary intention using dressing changes.</p><p><strong>Conclusions: </strong>The findings of this case report suggest that NPWT followed by conventional dressings can be used to close and heal the wound created by surgical hematoma evacuation.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1477926"},"PeriodicalIF":1.6,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11794497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DMMR status and synchronous lesions predicts metachronous lesions after curative resection for rectal cancer.","authors":"Xijie Chen, Junguo Chen, Liang Xu, Dezheng Lin, Xiaoling Hong, Junsheng Peng, Xiaowen He, Jiancong Hu","doi":"10.3389/fsurg.2025.1510400","DOIUrl":"10.3389/fsurg.2025.1510400","url":null,"abstract":"<p><strong>Background: </strong>There are no established standard colonoscopy surveillance protocols for patients after curative rectal cancer resection. We investigated the predictive factors for colorectal neoplasms during surveillance colonoscopies to identify patients who are at risk of developing metachronous neoplasms in the residual colorectum.</p><p><strong>Methods: </strong>This was a single-center, retrospective study that included patients with diagnosis of rectal carcinoma who had undergone curative resection from October 2012 to June 2018. Clinicopathological variables were analyzed by logistic regression analysis to identify risk factors independently associated with metachronous neoplasms in patients that underwent curative rectal cancer surgery.</p><p><strong>Results: </strong>In all, 554 patients were included in the analysis. Deficient mismatch repair (dMMR) status was recorded in 20 (3.6%) patients. At the surveillance colonoscopies, 118 patients (21.3%) had metachronous neoplasms while 169 patients (30.5%) had metachronous polyps. The median time interval between index colonoscopy and the last surveillance colonoscopy was 736.5 (476.75-1,082.25) days. Univariable and multivariable analysis showed dMMR status, synchronous adenomas/polyps, surveillance time > 3, and longer surveillance period patients were significant risk factors for development of metachronous lesions; in subgroup analysis, we also found that among rectal cancer patients with synchronous adenomas, adenomas located in the left colon and rectum, and longer surveillance period were independent risk factors for detecting metachronous adenomas.</p><p><strong>Conclusions: </strong>This study underscored the importance of extended follow-up protocols and targeted surveillance for identifying and managing metachronous lesions in dMMR rectal cancer patients, especially with synchronous adenomas. Further prospective, multicenter studies are needed to validate these results.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1510400"},"PeriodicalIF":1.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IMAGINER 2-improving accuracy with augmented realIty navigation system during placement of external ventricular drains over Kaufman's, Keen's, Kocher's and Frazier's point.","authors":"Martin Vychopen, Fabian Kropla, Dirk Winkler, Erdem Güresir, Ronny Grunert, Johannes Wach","doi":"10.3389/fsurg.2024.1513899","DOIUrl":"10.3389/fsurg.2024.1513899","url":null,"abstract":"<p><strong>Background: </strong>External ventricular drain (EVD) placement is a routine neurosurgical procedure used to treat acute hydrocephalus and monitor intracranial pressure. Kocher's point is the most commonly used anatomical landmark, but other entry points can be challenging even for experienced neurosurgeons. Augmented reality (AR) may enhance the accuracy and safety of these procedures. Previous studies demonstrated improved ventriculostomy accuracy using AR among novices. This study evaluates AR's impact on EVD placement accuracy performed by experienced neurosurgeons.</p><p><strong>Methods: </strong>Eighteen neurosurgical experts performed ventriculostomies on a Styrofoam head model using Kaufman's, Keen's, Kocher's, and Frazier's points. Punctures were performed freehand (Freehand group) and with AR assistance (AR group). Post-procedure CT scans were used to compare the actual catheter tip positions with the ideal positions. Accuracy was assessed by the distance between real and ideal catheter tips and by Kakarla grading.</p><p><strong>Results: </strong>The AR group had a mean tip distance of 16.93 ± 9.38 mm compared to 21.71 ± 9.69 mm in the Freehand group (<i>p</i> = 0.003). The AR group also showed better Kakarla grading outcomes (Grade 1: <i>n</i> = 26, Grade 3: <i>n</i> = 26) vs. the Freehand group (Grade 1: <i>n</i> = 7, Grade 3: <i>n</i> = 53; <i>p</i> < 0.0001). Neurosurgeons with ≥7 years of experience demonstrated higher accuracy across both methods (<i>p</i> = 0.040).</p><p><strong>Conclusion: </strong>AR significantly enhances the accuracy of EVD placement, particularly using Kaufman's, Keen's, Kocher's, and Frazier's points, with experienced neurosurgeons benefiting the most from AR assistance.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1513899"},"PeriodicalIF":1.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implantation of a totally implanted venous device unexpected discovery of left permanent superior vena cava in a patient with sigmoid colon cancer: a case report.","authors":"Shuchen Zhu, Mingyan Dong, Haiguan Luo, Yicui Piao, Qiaohong Zhang, Lihui Huang, Zijie Liu","doi":"10.3389/fsurg.2025.1428776","DOIUrl":"10.3389/fsurg.2025.1428776","url":null,"abstract":"<p><p>Persistent left superior vena cava (PLSVC) is an intrathoracic vascular malformation. Sigmoid colon cancer with a left superior vena cava (LSVC) is very rare. Totally implanted venous devices (TIVADs) are commonly used in recurrent chemotherapy for sigmoid colon cancer. We describe a case of unexpected finding of coronary sinus rhythm in intracavitary electrocardiogram localization TIVAD implantation. Intraoperative ultrasonography revealed a PLSVC.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1428776"},"PeriodicalIF":1.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of open femoral endarterectomy on treating multilevel iliac and common femoral artery occlusive disease.","authors":"Suehyun Park, Taewan Ku, Deokbi Hwang, Woo-Sung Yun, Seung Huh, Hyung-Kee Kim","doi":"10.3389/fsurg.2025.1445846","DOIUrl":"10.3389/fsurg.2025.1445846","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the impact of femoral endarterectomy (FE) on treating multilevel iliac and common femoral artery occlusive disease.</p><p><strong>Materials and methods: </strong>From January 2013 to December 2022, 106 limbs in 103 patients with multilevel arterial occlusive disease underwent open FE and iliac angioplasty (FEIA) with or without infrainguinal revascularization. The primary outcome assessment was the changes in the TransAtlantic Inter-Society Consensus (TASC) II classification during the operation; the secondary outcomes included the primary patency (PP) and secondary patency (SP) of FEIA. The risk factors for PP loss were evaluated.</p><p><strong>Results: </strong>Of the 103 patients, 91 were male. A total of 56 limbs were treated for chronic limb-threatening ischemia, and 61 limbs underwent infrainguinal revascularization. Preoperatively, aortoiliac occlusive disease (AIOD) was classified as TASC II C in 65 (61%) limbs and D in 41 limbs. During the operation, 19 limbs received additional thrombectomy for subacute or chronic thrombus components. Overall, FE and additional thrombectomy reduced the TASC II classification of AIOD from complex lesions (TASC II C/D) to simple lesions (B or lesser) in 101 (95%) of 106 limbs. Three early mortalities (2.8%, two from acute myocardial infarctions and one from pneumonia) were recorded. The PP and SP of FEIA were 89% and 96% at 1 year, 80% and 94% at 3 years, and 77% and 94% at 5 years, respectively. The severity of iliac and common femoral artery disease was not associated with PP loss of FEIA.</p><p><strong>Conclusions: </strong>Despite the challenging nature of initially classified TASC II C/D lesions, our findings highlight the effectiveness of FE in reducing TASC II classification and the durable patency achieved with FEIA. Hybrid FEIA could be a viable primary treatment option, particularly for lesions featuring severe iliac and common femoral artery disease.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1445846"},"PeriodicalIF":1.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}