Isolated Endarterectomy and Patch Angioplasty for Common Femoral Artery Occlusive Lesions

Abstract

Eleven patients underwent isolated common femoral artery endarterectomy and vein patch angioplasty over a five-year period. All patients had claudication. In addition 7 had rest pain and 2 had ischemic ulcerations. Mean age was 67.8 ± 11.2 years. The mean preoperative ankle/arm (a/a) index was 0.48 ±0.14. The operations were performed under local or regional anesthesia. There was no perioperative mortality or morbidity. The mean postoperative a/a index increased to 0.76 ±0.19 at 30.75 months. One reconstruction thrombosed at sixteen months. Two patients died of unrelated causes with patent grafts at six months. The increase in a/a index was the same irre spective of whether the presenting symptoms were claudication alone (0.29), rest pain (0.21), or ischemic ulceration (0.35). This study indicates that femoral endarterec tomy and patch angioplasty is a safe and durable procedure for focal common femoral artery stenosis or occlusion.

Get full access to this article

View all access options for this article.

References

dos Santos JC : Sur la deobstruction des thrombosis arterielle annciennies. Chirugie 73:409-411, 1944.

Hertzer NR , Arison R. : Cumulative stroke and survival ten years after carotid endarterectomy. J Vasc Surg 2:661-668, 1985.

Hertzer NR , Beven EG , O'Hara PJ , et al: A prospective study of vein patch angioplasty during carotid endarterectomy. Ann Surg 207:628-635, 1987.

Hansen KJ , Starr SM , Sands RE , et al: Contemporary surgical management of renovascular disease. J Vasc Surg 16:319-331, 1992.

Martin P. , Renwick S. , Stephenson C. : On the surgery of the profunda femoris artery. Br J Surg 55:539, 1968.

Edwards WS : Composite reconstruction of the femoral artery with saphenous vein after endarterectomy . Surg Gynecol Obstet 111:651-653, 1960.

Ad Hoc Committee on reporting standards suggested for reports dealing with lower extremity ischemia. J Vasc Surg 4:80-94, 1986.

Canon JA , Barker WF : Successful management of obstructive femoral arteriosclerosis by endarterectomy . Surgery 38:48-60, 1955.

McGovern PJ Jr, Stark KR , Kaufman JL , et al: Management of common femoral artery occlusion. A report of 10 cases. J Cardiovasc Surg 28:38-41, 1987.

10.

Mukherjee D. , Inahara T. : Endarterectomy as the procedure of choice for atherosclerotic occlusive lesions of the common femoral artery. Am J Surg 157:498-500, 1989.

11.

Liekweg WC , Greenfield LJ : Vascular prosthetic infections—collected experience and results of treatment . Surgery 81:335-342, 1977.

12.

Miller T. , Niazmand R. , Barker WF : Femoral artery reconstruction under local anesthesia. Am J Surg 122:513, 1971.

13.

Criado E. , Burnham SJ , Tinsley EA Jr , et al: Femorofemoral bypass graft: Analysis of patency and factors influencing long-term outcome. J Vasc Surg 18:495-505, 1993.