Darwish Maram, Davies Huw Owain, Morgan Emily, Meecham Lewis
Vascular Surgery, Cardiff and Vale University Health Board, Cardiff, UK.
Health Education East Midlands, Nottingham, UK.
BMJ Open. 2025 Jun 19;15(6):e096955. doi: 10.1136/bmjopen-2024-096955.
Peripheral artery disease (PAD) is a chronic condition causing arterial narrowing or blockage, leading to significant morbidity and mortality. Hybrid revascularisation combines open surgical and endovascular techniques to manage multilevel disease by addressing inflow and outflow obstructions. Despite increasing adoption, evidence on the long-term outcomes of these procedures remains limited.
To evaluate the long-term outcomes of hybrid revascularisation procedures in PAD, including patency rates, limb salvage, survival, reintervention rates and complications, and to provide evidence-based insights for clinical practice and research.
This review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. It will include randomised controlled trials, cohort studies, case-control studies and large case series (≥10 patients, with at least 1 year of follow-up) assessing adult patients undergoing hybrid revascularisation for PAD. Primary outcomes are patency rates, limb salvage and survival; secondary outcomes include complication rates, functional improvements and quality of life. Searches will be conducted in PubMed, Embase, Cochrane Library, CINAHL and ClinicalTrials.gov. Study selection, data extraction and quality assessment will be performed independently in duplicate by two reviewers. Meta-analyses with random-effects models will summarise findings where feasible, while narrative synthesis will address instances of insufficient data. Subgroup analyses will explore outcomes by demographics, lesion characteristics and procedural details. Risk of bias will be assessed using Cochrane and Newcastle-Ottawa tools.
Ethical approval is not required. Findings will be published in peer-reviewed journals and presented at conferences.
CRD42024615809.
外周动脉疾病（PAD）是一种导致动脉狭窄或阻塞的慢性疾病，会引发严重的发病率和死亡率。杂交血管重建术结合了开放手术和血管内技术，通过解决流入和流出道阻塞来治疗多节段疾病。尽管其应用越来越广泛，但关于这些手术长期疗效的证据仍然有限。
评估PAD杂交血管重建术的长期疗效，包括通畅率、肢体挽救情况、生存率、再次干预率和并发症，并为临床实践和研究提供基于证据的见解。
本综述将遵循系统评价和Meta分析的首选报告项目（PRISMA）指南。将纳入随机对照试验、队列研究、病例对照研究和大型病例系列（≥10例患者，至少随访1年），评估接受PAD杂交血管重建术的成年患者。主要结局为通畅率、肢体挽救情况和生存率；次要结局包括并发症发生率、功能改善和生活质量。将在PubMed、Embase、Cochrane图书馆、CINAHL和ClinicalTrials.gov中进行检索。研究选择、数据提取和质量评估将由两名 reviewers 独立进行重复操作。可行时，将采用随机效应模型进行Meta分析以总结结果，而叙述性综合分析将处理数据不足的情况。亚组分析将按人口统计学、病变特征和手术细节探讨结局。将使用Cochrane和纽卡斯尔 - 渥太华工具评估偏倚风险。
无需伦理批准。研究结果将发表在同行评审期刊上，并在会议上展示。
PROSPERO注册号：CRD42024615809。
