Retrograde endarterectomy of iliac arteries

Authors retrospectively analyze a group of patients with symptomatic peripheral arterial occlusive disease (PAOD) who underwent an arterial reconstruction with a remote retrograde endarterectomy combined with intraoperative angiography and endovascular techniques as a hybrid procedure.

During the year 2007, there were 83 patients with PAOD planned for the remote retrograde endarterectomy of the iliofemoral arteries. Due to perioperative findings or complications, in 11 cases (13.25%) an alternative vascular procedure was necessary. In 52 (62.65%) patients the remote endarterectomy of iliofemoral arteries was performed separately or in connection with the endarterectomy of femoral bifurcation or bypass. In 20 (24.1%) patients, the remote endarterectomy was performed as a part of hybrid procedure. A technical success was achieved in 72 (from 83 patients - 86.7%) and a clinical success in 71 (from 72 patients - 98.6%) patients in whom a successful remote retrograde endarterecomy was performed. There were 15 operations needed in the postoperative period, but only two of them were necessary because of close relation with an unfavorable outcome after the remote endarterectomy. No perioperative and postoperative mortality was observed in the whole group of patients. During the follow up in the next 6 months, patency was proved in all patients after a successful remote endarterectomy.

Endovascular techniques in vascular surgery, remote endarterectomy is in our opinion a safe and durable method in the therapy of selected patients with PAOD (Tab. 4, Fig. 3, Ref. 8). Full Text (Free, PDF) www.bmj.sk.