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Related Experiment Videos

Remote endarterectomy: lessons learned after more than 100 cases.

John D Martin1, Jon A Hupp, Mark O Peeler

  • 1Anne Arundel Medical Center, Annapolis, MD 21401, USA.

Journal of Vascular Surgery
|February 16, 2006
PubMed
Summary

Remote endarterectomy offers a durable alternative for extensive iliac and superficial femoral artery occlusive disease, demonstrating comparable patency rates to bypass procedures and potentially becoming the preferred treatment for long-segment occlusions.

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Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Peripheral Artery Disease

Background:

  • Bypass procedures are standard for extensive external iliac and superficial femoral artery (SFA) occlusive disease.
  • Remote endarterectomy from a groin incision has shown promise in Europe but limited adoption in the US.
  • This study investigates the technical aspects and durability of remote endarterectomy.

Purpose of the Study:

  • To evaluate the feasibility and long-term outcomes of remote endarterectomy for extensive external iliac and SFA occlusive disease.
  • To compare the durability and patency rates of remote endarterectomy with traditional bypass procedures.
  • To assess the technical challenges and success rates of the remote endarterectomy technique.

Main Methods:

  • Remote endarterectomy was the primary surgical option for eligible patients with external iliac and SFA occlusive disease.

Related Experiment Videos

  • Patient data were prospectively collected and retrospectively reviewed.
  • Postoperative surveillance included duplex ultrasound assessments.

    • Main Results:

    • Remote endarterectomy was performed in 133 patients, with a mean age of 68 years; 68% were male, and 31% were diabetic.
    • Technical issues led to conversion to bypass in 12% of cases. Successful endarterectomy was achieved in 117 patients.
    • At a mean follow-up of 19 months, primary patency was 70% at 30 months, with a limb salvage rate of 94%.

    Conclusions:

    • Remote endarterectomy is a viable and durable alternative to bypass for external iliac and SFA occlusive disease.
    • The procedure demonstrates comparable patency to bypass and endovascular interventions.
    • Remote endarterectomy may become the preferred treatment for long-segment occlusions in these vessels.