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Common femoral artery endarterectomy in the age of endovascular therapy
- Source :
- Vascular. 26:581-590
- Publication Year :
- 2018
- Publisher :
- SAGE Publications, 2018.
-
Abstract
- Objectives Common femoral artery endarterectomy (CFE) is the standard treatment for common femoral artery occlusive disease. We aim to assess the medium term outcomes of CFE with or without further concomitant procedures. Design A retrospective observational study. Methods All patients who underwent either isolated CFE (ICFE), CFE with angioplasty for occlusive arterial disease (CFEA) or concomitant CFE with endovascular aortic aneurysm repair (CFEE) were included. Patient demographics follow up, clinical improvement, types of CFE closure, patency rates, and survival-free amputation were noted. Results From 2002 to 2015, 1512 patients were referred with a diagnosis of critical limb ischemia. Of those, 1134 required revascularization. Sixty-one patients underwent 66 CFE. Ten limbs underwent an ICFE, 35 had CFEA, and 21 underwent CFEE. Demographics were comparable in all groups. Twenty-seven were closed primarily, while 39 required patch closure (12 venous, 8 Dacron, 19 biological). Technical success was 100% in ICFEs, 94% in CFEA, and 100% for CFEE ( p = 0.274). Immediate clinical success was 100% in both CFE and CFEE, but was 85.7% in CFEA ( p = 0.035). Immediate hemodynamic success was similar in all three groups ( p = 0.73). Sustained hemodynamic success was 30% in ICFE, 54.3% in CFEA, and 23.8% in CFEE ( p = 0.056). At two years, the primary patency was 90% in ICFE, 74.3% in CFEA, and 100% in CFEE ( p = 0.049). Primary-assisted patency was 90% in ICFE, 82.9% in CFEA, and 100% in CFEE ( p = 0.17). Secondary patency was 90% in ICFE, 94.3% in CFEA, and 100% in CFEE ( p = 0.409). Re-intervention was required in 26.9% of primary closures, versus 12.8% with patch closures ( p = 0.279). Amputation-free survival was 100% in ICFE, 80% in CFEA, and 100% in CFEE ( p = 0.056). Conclusion CFE is a reliable and dependable procedure, even in the absence of good distal runoff.
- Subjects :
- Male
medicine.medical_specialty
Time Factors
medicine.medical_treatment
Occlusive disease
Endarterectomy
Femoral artery
030204 cardiovascular system & hematology
Endovascular therapy
Amputation, Surgical
Disease-Free Survival
Medium term
Peripheral Arterial Disease
03 medical and health sciences
0302 clinical medicine
Risk Factors
medicine.artery
Humans
Medicine
Radiology, Nuclear Medicine and imaging
030212 general & internal medicine
Vascular Patency
Aged
Retrospective Studies
Aged, 80 and over
business.industry
Standard treatment
Angioplasty
General Medicine
Middle Aged
Limb Salvage
Surgery
Femoral Artery
Treatment Outcome
Female
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 1708539X and 17085381
- Volume :
- 26
- Database :
- OpenAIRE
- Journal :
- Vascular
- Accession number :
- edsair.doi.dedup.....bee42aeffdc11faee09a0420d1497a03
- Full Text :
- https://doi.org/10.1177/1708538118772682