Remote superficial femoral artery endarterectomy: medium-term results.
BACKGROUND
the aim of this study is to determine the medium-term results following successful remote superficial-femoral endarterectomy (RSFE).


METHODS
district general hospital in United Kingdom.


METHODS
RSFE comprises a single incision over the origin of the superficial femoral artery. The endarterectomy is carried out in a closed fashion from above. The cut end of distal atheroma is secured with a stent. Twenty-five limbs were followed up with three monthly duplex scans and angiography if any abnormality was suggested. All patients presented with intermittent claudication; in addition three had rest pain and three ulceration or gangrene. The length of atheromatous core removed was 10-30 cm.


RESULTS
all patients had a follow-up of at least one year (range 12-27 months). Eleven arteries developed 14 stenoses. Nine became apparent within nine months of RSFE. The cumulative risk of stenoses developing in patent arteries was 24% at 6 and 63% at 12 months. Eleven angioplasties (PTA) of these stenoses were undertaken. Nine of these remain patent at a median of 12 months after PTA. At one year primary patency was 10 of 25 (40%), primary-assisted patency 18 of 25 (72%) and secondary patency 19 of 25 (76%) and at two years 29%, 57% and 57% respectively.


CONCLUSIONS
RSFE is worth considering for superficial femoral artery occlusive disease, particularly in high-risk patients without suitable vein and with limited life expectancy. Careful duplex surveillance is important. Until stenoses can be prevented, the widespread use of RSFE cannot be recommended.
Galland
R B
RB
Department of Surgery, Royal Berkshire Hospital, Reading, UK.
Whiteley
M S
MS
Gibson
M
M
Simmons
M J
MJ
Torrie
E P
EP
Magee
T R
TR
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D017130:Angioplasty; D001157:Arterial Occlusive Diseases / Q000209:etiology; D001161:Arteriosclerosis / Q000601:surgery; D003251:Constriction, Pathologic / Q000209:etiology; D004691:Endarterectomy; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005500:Follow-Up Studies; D005734:Gangrene / Q000601:surgery; D006801:Humans; D007383:Intermittent Claudication / Q000601:surgery; D007871:Leg Ulcer / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012086:Reoperation; D012307:Risk Factors; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D014654:Vascular Patency