Remote superficial femoral artery endarterectomy: early results for TASC D lesions in patients with severe ischemia.
Endovascular treatment for Transatlantic Inter-Society Consensus (TASC) D lesions of the superficial femoral artery has been disappointing. This has been attributed to a bulking atheromatous plaque. Debulking the superficial femoral artery allows for a larger lumen, whereas covering the lumen with an endograft provides in-line flow. We evaluated the intermediate results of remote superficial femoral artery endarterectomy with covered endograft placement in 18 patients. Patient demographic, vascular laboratory, and preoperative data were gathered retrospectively. The procedure was technically successful in all the patients. The mean age was 62.2 +/- 9.9 years. Ankle brachial index improved from 0.35 +/- 0.1 to 0.86 +/- 0.1. The cumulative 12-month primary patency was 42.2%, whereas assisted primary or secondary patency was 70.8%. Five endografts occluded within the 12 months. Two of those patients underwent subsequent femoral-to-below-knee bypass, whereas 2 had major amputations. Remote superficial femoral artery endarterectomy can be reasonably offered if an autogenous conduit is not available for revascularization of the superficial femoral artery.
Ali
Ahsan T
AT
Division of Vascular Surgery, Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA. aali@uams.edu
Kalapatapu
Venkat
V
Ahmed
Omar
O
Moursi
Mohammed
M
Eidt
John F
JF
D000497:Alloys; D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D004691:Endarterectomy / Q000379:methods*; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006083:Graft Occlusion, Vascular; D006801:Humans; D007089:Image Enhancement; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply; D008297:Male; D012008:Recurrence; D012086:Reoperation; D015607:Stents; D015996:Survival Rate; D016896:Treatment Outcome; D014654:Vascular Patency
D000497:Alloys; C013616:nitinol