Abstract
To retrospectively analyse long-term outcome of common femoral endarterectomy (CFE) at a single tertiary referral centre. A review of outcome following CFE was performed. Freedom from reintervention in ipsilateral limb and limb salvage were determined using Kaplan-Meier life-table analysis. Factors associated with adverse outcome were assessed by Cox Regression analysis. CFE was performed on 87 limbs in 81 patients (mean age 71 ± 11; male 69%). 45 (52%) were performed for incapacitating claudication and 42 (48%) for critical limb ischaemia. 25 (29%) were performed with adjunctive inflow or outflow procedures. CFE was combined with profundaplasty in 74 (85%) and patch angioplasty in 85 (98%) patients. Technical success rate was 100% with 30-day clinical success of 96%. Mean postoperative increase in ABPI was 0.32 ± 0.19. There were 4 (5%) major and 8 (9%) minor complications with 1 (1%) perioperative death. Mean follow-up was 23 months (range 1-144 months). Primary patency and assisted patency at 3 years were 93% and 99% respectively. There was no difference in patency in CFE performed alone or as combined procedure. No patient-related or intraoperative factors were associated with increased risk of recurrence of symptoms. Freedom from reintervention in ipsilateral limb was 79% at 2 years and 62% at 6 years. Freedom from amputation at 6 years was 87% and significantly increased amputation risk was identified in patients on haemodialysis for chronic renal failure (by long-rank test, p< 0.001***). Common Femoral Endarterectomy is safe, durable and effective and can be performed under local anaesthesia which is helpful for limb salvage in unfit patients. It is gold standard for occlusive CFA disease against which emerging endovascular therapies should be compared.
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