title: Incidence and survival outcome following femoral artery reconstruction during endovascular abdominal aortic aneurysm repair.
abstract: BACKGROUND
  Planned or unplanned reconstruction of the common femoral artery (femoro-femoral crossover and/or patch closure) may be required following endovascular abdominal aortic aneurysm repair (EVAR) stent graft deployment for arterial closure or maintenance of limb perfusion. The aim of this study was to examine the incidence of common femoral artery reconstruction (FAR) following EVAR and examine the effect on patient survival.
  
  
  METHODS
  A total of 178 patients undergoing EVAR were studied retrospectively.
  
  
  RESULTS
  In all, 31 patients (17.4%) underwent FAR; 16 (51.6%) femoro-femoral crossover, and 15 (48.4%) endarterectomy and patch closure. All cause survival in patients undergoing FAR was significantly poorer than those undergoing direct closure (P = .010).A total of 3 factors: the need for FAR (hazard ratio [HR] = 0.435, P = .006), chronic obstructive pulmonary disease ([COPD] HR = 0.424, P = .002), and abdominal aortic aneurysm (AAA) size (HR = 1.414, P = .005) were significantly and independently associated with survival on forward conditional analysis.
  
  
  CONCLUSIONS
  Femoral artery reconstruction was performed in almost 1 in 5 patients undergoing EVAR and associated with decreased survival. Multidisciplinary teams should be aware of these findings when planning EVAR, especially in borderline candidates.
authors.affiliation: Department of Vascular Surgery, University Hospital of Wales, Cardiff, UK.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Twine
authors.forename: Andrew
authors.initials: A
authors.lastname: Wood
authors.forename: Andrew
authors.initials: A
authors.lastname: Gordon
authors.forename: Susan
authors.initials: S
authors.lastname: Hill
authors.forename: Richard
authors.initials: R
authors.lastname: Whiston
authors.forename: Ian M
authors.initials: IM
authors.lastname: Williams
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality*; D016009:Chi-Square Distribution; D057510:Endovascular Procedures / Q000009:adverse effects / Q000401:mortality*; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014852:Wales