Remote superficial femoral endarterectomy: Long-term results.
OBJECTIVE
The aim of this study was to determine long-term results following successful remote superficial femoral endarterectomy (RSFE).


METHODS
RSFE is a minimally invasive technique of revascularising the superficial femoral artery. A single incision was made over the origin of the superficial femoral artery. The endarterectomy was carried out in a closed fashion from above. The cut end of distal atheroma was secured with a stent. Following RSFE patients were followed up with intravenous digital subtraction angiography (IVDSA) and 3-monthly duplex scans. IVDSA was repeated if any abnormality was found.


RESULTS
RSFE was attempted on 30 patients with 33 symptomatic legs to treat tissue loss (n = 3), rest pain (n = 3) or intermittent claudication (n = 27). In 26 limbs it was possible to complete the RSFE satisfactorily (technical success 79%), but during follow-up 18 later developed stenoses. Of 31 stenoses detected, 27 were treated by angioplasty. Primary patency at 1, 2 and 5 years was 38, 31 and 16%, respectively. Primary-assisted patency at 1, 2 and 5 years was 77, 65 and 60%.


CONCLUSIONS
Primary-assisted patency following RSFE is reasonable, however, it is only achieved with life-long surveillance and intervention. Until results can be improved the widespread use of RSFE cannot be recommended.
Devalia
K
K
Department of Surgery, Royal Berkshire Hospital, London Road, Reading RG1 5AN, UK.
Magee
T R
TR
Galland
R B
RB
D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity; D004691:Endarterectomy / Q000379:methods*; D005260:Female; D005263:Femoral Artery; D006801:Humans; D008297:Male; D008875:Middle Aged; D018616:Ultrasonography, Doppler, Duplex; D014654:Vascular Patency