Semi-closed femoropopliteal thromboendarterectomy: a prospective study.
OBJECTIVE
to study the primary patency rates of angioscopically controlled thromboendarterectomies of the superficial femoral artery.


METHODS
prospective open study.


METHODS
between 1990 and 1995, femoropopliteal thromboendarterectomies were performed in 63 patients (41 male, 22 female). Postoperative follow up was performed at 3- to 6-month intervals using non-invasive pressure measurements plus IVDSA at 1 year.


RESULTS
eight patients were not evaluable, leaving 55 patients eligible for follow-up analysis. Postoperative complications (arteriovenous fistulas, false aneurysms) were observed in 5.4% of patients. Immediate perioperative occlusions occurred in 7.3%, early occlusions in 21.8% and late occlusions in 16.4% of all cases. The mean follow-up was approximately 57 months. The mean primary patency rate at 5 years was 44.5% (28 patients with the superficial femoral artery still open). Six patients died during the follow-up period.


CONCLUSIONS
in contrast to the very positive reports found in recent literature, this prospective study shows a lower five-year patency rate for semi-closed femoropopliteal thromboendarterectomy than for bypass grafting. Thromboendarterectomy cannot be considered as a standard procedure in revascularisation of the femoropopliteal region.
Heider
P
P
Department of Vascular Surgery, Klinikum rechts der Isar, Munich, Germany.
Hofmann
M
M
Maurer
P C
PC
von Sommoggy
S
S
D000368:Aged; D001157:Arterial Occlusive Diseases / Q000601:surgery; D002908:Chronic Disease; D004691:Endarterectomy / Q000379:methods*; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007383:Intermittent Claudication / Q000601:surgery; D007511:Ischemia / Q000601:surgery; D007866:Leg / Q000098:blood supply; D008297:Male; D011150:Popliteal Artery / Q000601:surgery; D011183:Postoperative Complications; D011446:Prospective Studies; D016896:Treatment Outcome; D014654:Vascular Patency