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Effectiveness of remote endarterectomy in superficial femoral artery occlusion

Burak Koçak¹, Bülent Mert², Sinan Güzel³, Kamil Boyacıoğlu<sup>2

1</sup>Department of Cardiovascular Surgery, Niğde Training and Research Hospital, Niğde, Türkiye
²Department of Cardiovascular Surgery, Bağcılar Training and Research Hospital, İstanbul, Türkiye
³Department of Cardiovascular Surgery, Dörtyol Public Hospital, Hatay, Türkiye

Keywords: Femoropopliteal bypass, peripheral artery disease, remote endarterectomy

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Objectives: The study aimed to evaluate the one-year patency rates of patients who underwent remote endarterectomy (RE) and compare them with femoral-popliteal bypass (FPB) surgery.

Patients and methods: The single-center observational study included 48 consecutive patients (46 males, 2 females; mean age: 60.0±6.1 years; range, 48 to 73 years) who underwent RE (n=24) or FPB surgery (n=24), which was performed solely for peripheral artery disease, between January 2017 and January 2022. Demographic and clinical data of the patients and data related to the procedures and follow-up were obtained from hospital records, and the evaluations were performed retrospectively. The exclusion criteria were defined as being under 18 years of age and undergoing FPB following trauma.

Results: While 21 (87.5%) of the patients who underwent RE had a lesion in the popliteal artery, none of the patients who underwent FPB had a popliteal artery lesion. The one-year patency rate in patients who underwent RE and FPB was 73.9% and 62.5%, respectively. Although the Global Limb Anatomical Staging System scores of patients who underwent RE were more advanced, patency rates were found to be higher. The number of patients who underwent RE and required revascularization within the first week was five (21.7%), and all of these procedures were performed endovascularly. In the FPB group, the number of patients requiring revascularization was two (8.3%), and embolectomy was performed in these patients.

Conclusion: Remote endarterectomy may be a good option in patients who have long-segment lesions, in those who previously underwent FPB surgery, in patients who require repeated intragraft embolectomy revisions, in those with limited access for endovascular procedures, in patients with graft infections, and in those who cannot use prosthetic materials.

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