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Remote endarterectomy: an alternative to surgical bypass

A R Chandrashekar1, Rajendra Prasad B1, Sanjay C Desai1

  • 1Department of Vascular Surgery, M.S. Ramaiah Medical College and Hospitals, MSR Nagar, MSRIT Post, Bengaluru-560054 Karnataka, India.

The Indian Journal of Surgery
|January 16, 2014
PubMed

Insights

Remote endarterectomy offers a durable solution for peripheral artery disease, showing high patency rates up to five years. This minimally invasive approach combines surgical and endovascular benefits for effective treatment.

Area of Science:

  • Vascular Surgery
  • Minimally Invasive Procedures
  • Peripheral Artery Disease

Background:

  • Peripheral artery disease (PAD) significantly impacts patient quality of life.
  • Standard bypass procedures carry risks, especially in patients with comorbidities.
  • Remote endarterectomy presents a potential alternative for PAD treatment.

Purpose of the Study:

  • To evaluate the preliminary outcomes of remote endarterectomy.
  • To assess the efficacy and durability of this technique in treating ileofemoral and femoropopliteal disease.

Main Methods:

  • Retrospective analysis of 15 patients (18 limbs) undergoing remote endarterectomy between June 2003 and June 2010.
  • Inclusion of patients with unilateral/bilateral ileofemoral or femoropopliteal disease.
  • Inclusion of patients with significant comorbidities such as diabetes, hypertension, cardiac disease, and smoking.

Main Results:

  • 100% patency at 3 months (one lost to follow-up).
  • 90.90% overall success rate at one year, with one case requiring conversion to aorto-femoral bypass due to disease progression.
  • Complete recovery of tissue loss in all affected patients within 3 months.
  • A 5-year patency rate of 74% was observed.

Conclusions:

  • Remote endarterectomy is a viable and durable alternative to standard bypass procedures for PAD.
  • The technique effectively combines minimally invasive surgery with endovascular approaches.
  • Positive outcomes in patients with complex PAD and comorbidities support its continued use.

Keywords:
Femoro popliteal diseaseIleofemoral diseaseMoll’s ring cutterRemote endarterectomy

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