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Remote Superficial Femoral Artery Endarterectomy
Derenik Maytesyan, MD, PhD, Simon A. Papoyan, MD PhD, Igor Abramov, MD, PhD, Andrey Eremenko, Victor Baldin, MD, PhD, Andrey Verigo, MD, PhD.
15 Moscow municipal Hosptal, moscow, Russian Federation.
Background: the aim of this study is to determine the medium-term results following successful remote superficial femoral endarterectomy (RSFE).
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.
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