A single-center experience in the eversion femoral endarterectomy

Area of Science:

• Vascular Surgery
• Surgical Techniques
• Arterial Disease Management

Background:

• Standard treatment for femoral bifurcation occlusive disease involves longitudinal arteriotomy and prosthetic patch angioplasty.
• Increasing concerns regarding prosthetic-related infections and multidrug-resistant pathogens necessitate alternative surgical approaches.
• Eversion femoral endarterectomy presents a viable alternative to conventional methods.

Purpose of the Study:

• To evaluate the safety and efficacy of eversion femoral endarterectomy.
• To assess the outcomes, including patency rates and complications, of this alternative surgical technique.
• To present the institutional experience with eversion femoral endarterectomy.

Main Methods:

• Retrospective analysis of patients undergoing eversion femoral endarterectomy between 2016 and 2019.
• Data collection included patient demographics, surgical details, and postoperative complications.
• Follow-up data were analyzed to determine patency rates and adverse events.

Main Results:

• Nineteen patients (84.2% male, median age 67 years) underwent the procedure with a median follow-up of 180 days.
• Primary patency rates were 100% at 6 months and 87.5% at 12 months; primary-assisted and secondary patency rates were 100%.
• The 30-day mortality rate was 5.3%, and the complication rate was 10.5%, including one case of rhabdomyolysis-related renal disease and one fatal ischemia-reperfusion injury.

Conclusions:

• Eversion femoral endarterectomy is a safe and feasible surgical option for femoral bifurcation disease.
• The technique achieves favorable patency rates and adheres to the principle of leaving no foreign material in situ.
• Meticulous control of proximal and distal arteriotomy margins is crucial for successful outcomes.