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Related Experiment Videos

Aortofemoral thromboendarterectomy.

Eduardo Toledo de Aguiar1, Alex Lederman, Cid José Sitrangulo

  • 1Vascular Surgery Service, Hospital das Clínicas, Faculty of Medicine, University of São Paulo, Brazil.

Revista Do Hospital Das Clinicas
|September 24, 2002
PubMed
Summary

Aortofemoral thromboendarterectomy is a feasible surgical option for atherosclerotic obstruction, demonstrating low mortality and high long-term patency rates, particularly for intermittent claudication. However, outcomes are poorer for diabetic patients and those with associated femoropopliteal disease.

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Area of Science:

  • Vascular Surgery
  • Cardiovascular Medicine
  • Surgical Outcomes Research

Background:

  • Atherosclerotic obstruction of the aortofemoral arteries significantly impacts patient mobility and cardiovascular health.
  • Surgical intervention is often necessary to restore blood flow and prevent limb loss.
  • Endarterectomy is a potential treatment, but its feasibility and long-term efficacy require evaluation.

Purpose of the Study:

  • To assess the feasibility of aortofemoral endarterectomy in patients with atherosclerotic obstruction.
  • To evaluate the early and late results, including patency, survival, and complication rates.
  • To identify factors influencing surgical outcomes.

Main Methods:

  • A prospective, descriptive study involving 71 patients undergoing ring-stripper endarterectomy for aortofemoral atherosclerotic obstruction.

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  • Patients were analyzed based on age, gender, symptoms, diabetes, and extent of disease.
  • Statistical analysis included Chi-square, Fisher exact, and Wilkoxon (Gehan) tests.

    • Main Results:

    • Aortofemoral endarterectomy was feasible in 100% of patients at discharge, with a 4.2% mortality rate.
    • The 5-year survival rate was 83.3%, and the 5-year patency rate was 87.0%.
    • Higher amputation rates were observed in diabetic patients and those with femoropopliteal obstruction; these factors, along with age >65, negatively impacted survival.

    Conclusions:

    • Aortofemoral thromboendarterectomy is a viable procedure for approximately 90% of patients with aortofemoral atherosclerotic obstruction.
    • The procedure offers low early mortality and high late patency rates.
    • Diabetic patients and those with concomitant femoropopliteal disease face increased risks, necessitating careful patient selection and management.