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  • Title: Remote endarterectomy: first choice in surgical treatment of long segmental SFA occlusive disease?
    Author: Smeets L, Ho GH, Hagenaars T, van den Berg JC, Teijink JA, Moll FL.
    Journal: Eur J Vasc Endovasc Surg; 2003 Jun; 25(6):583-9. PubMed ID: 12787704.
    Abstract:
    OBJECTIVES: to report the long term results of remote superficial femoral artery endarterectomy (RSFAE) with the MollRing Cutter for the treatment of long segmental SFA occlusive disease. DESIGN: retrospective open study. PATIENTS AND METHODS: from March 1994 to August 2000 183 RSFAEs were performed in 164 selected patients (105 males, 120 procedures) with a median age of 63 years (43-84 years). Indications for operation were disabling intermittent claudication in 129 procedures (70%), rest pain in 20 procedures (11%), and limb salvage in 34 procedures (19%). Follow up consisted of clinical evaluation, ankle-brachial index measurements and duplex scanning. RESULTS: the mean follow-up time was 29.3 months. The mean length of the endarterectomised SFAs was 31 cm (range, 17-45cm). The five year cumulative primary patency rate by means of life table analysis was 37.8+/-6.67% (SE). Percutaneous transluminal balloon angioplasty and surgical re-intervention were performed in twenty-nine and four patients respectively resulting in a primary assisted patency rate of 47.9+/-6.27%. Limb salvage was achieved in 30 of the 34 patients. Females had a statistically significant lower primary patency rate, i.e., 26 vs 45% (p -value=0.01). CONCLUSIONS: the long term results of remote SFA endarterectomy show that it is a safe, effective and durable, minimally invasive procedure. It also leaves open all other options for conventional bypass procedures. The five-year primary patency rate is at least similar to prosthetic above-knee bypass surgery.
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