Remote Endarterectomy: First Choice in Surgical Treatment of Long Segmental SFA Occlusive Disease?

Abstract

The authors report the long-term results of a retrospective open study of remote superficial femoral artery endarterectomy. Between march 1994 and August 2000, 183 remote superficial femoral artery endarterectomy procedures were done in 163 patients. Indications for operation were limb salvage in 19% (34 procedures), disabling intermittent claudication in 70% (129 procedures) and rest pain in 11% (20 procedures. Patients were followed for a mean time of 29.3 months with clinical evaluation, duplex scanning, and ankle-brachial index measurements. At 5 years, the patency rate (life table analysis) was 37.8 ′ 6.76 (SE). Thirty-three patients required re-intervention (percutaneous transluminal balloon angioplasty in 29 and surgical in 4), which resulted in a primary assisted patency rate of 47.9 ′ 6.27%. Four patients out of 34 required amputation. The authors concluded that the minimally invasive remote superficial femoral artery endarterectomy procedure is a safe, effective, and durable, and allows other options for conventional bypass procedures, if necessary.