Vasc Spec Int.  2022 Dec;38(4):32. 10.5758/vsi.220040.

Outcomes of Isolated Endarterectomy and Patch Angioplasty of the Common Femoral Artery According to Current Inclusion Criteria for Endovascular Treatment

• Park S
• Ku T
• Hwang D
• Yun WS
• Kim HK
• Huh S

• KMID: 2538113
• DOI: http://doi.org/10.5758/vsi.220040

Abstract

Purpose
This study aimed to evaluate the outcomes of isolated common femoral endarterectomy with patch angioplasty (IFEA) in the endovascular era.
Materials and Methods
In 2012-2022, 189 limbs underwent femoral endarterectomy with patch angioplasty. Of them, 45 IFEAs were included. We evaluated safety based on early complications; efficacy with primary patency (PP) and reintervention, above-ankle amputation, or stenosis (RAS)-free survival. We also evaluated lesion characteristics and outcomes according to the inclusion criteria (IC) of vascular mimetic implant-common femoral artery (VMI-CFA) stenting trial.
Results
Forty-one patients were male, and 30 IFEAs were required for claudication. No cases of early mortality occurred. Ten limbs (22%) developed local/nonvascular complications (hematoma, 3; lymphocele, 5; wound infection, 2), of which 8 resolved spontaneously. The overall PP and secondary patency rates were 100% at 1 year and 87% and 97% at 3 years, respectively. Twenty-one lesions (47%) did not meet the IC. The PP within the IC was 100% at 1 and 3 years, and the PP outside the IC was 100% at 1 year and 73% at 3 years (P=0.068). The overall RAS-free survival rates were 91% at 1 year and 81% at 3 years. All cases of RAS occurred in lesions outside the IC. The multivariate analysis showed that dialysis was associated with poor RAS-free survival (adjusted odds ratio, 8.56; 95% confidence interval, 1.9-35.5; P=0.005).
Conclusion
The recent VMI-CFA trial results should be interpreted with caution. IFEA is a low-risk and durable procedure; however, careful follow-up is warranted in patients undergoing dialysis.

Keyword

Endarterectomy; Common femoral artery; Stents; Treatment outcome