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Long-Term Outcome of Common Femoral Artery Endarterectomy In Octogenarians and Non-Octogenarians

Christian Uhl1, Hannah Götzke2, Florian Zeman3

  • 1Clinic of Vascular Surgery, Krankenhaus Barmherzige Brüder Regensburg, Pruefeningerstrasse 81, Regensburg, 93049, Germany.

Scandinavian Journal of Surgery : SJS : Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society
|February 27, 2020
PubMed

Insights

Common femoral artery endarterectomy is a safe procedure for treating arteriosclerotic disease, offering excellent long-term results. However, octogenarians face higher risks for perioperative mortality and major amputation.

Area of Science:

  • Vascular Surgery
  • Arterial Disease Management
  • Geriatric Cardiovascular Health

Background:

  • Arteriosclerotic disease of the common femoral artery (CFA) necessitates intervention.
  • Surgical versus endovascular approaches are available for CFA disease.
  • Limited data exist on surgical outcomes in elderly patients.

Purpose of the Study:

  • To evaluate the safety and efficacy of common femoral artery endarterectomy (CFAE) in elderly patients.
  • To compare outcomes between patients younger than 80 years and those 80 years or older.
  • To identify risk factors influencing outcomes after CFAE.

Main Methods:

  • Retrospective analysis of 977 CFAEs performed between March 2007 and July 2018.
  • Patients were divided into two groups: <80 years (Group 1) and ⩾80 years (Group 2).
  • Primary endpoints included patency rates, limb salvage, and overall survival.

Main Results:

  • Thirty-day mortality was significantly higher in Group 2 (7.6%) compared to Group 1 (1.6%).
  • Major amputation rates at 30 days were also higher in Group 2 (2.9%) versus Group 1 (0.7%).
  • While limb salvage was comparable, overall survival was significantly lower in octogenarians (15.7%) versus younger patients (59.1%).

Conclusions:

  • Common femoral artery endarterectomy demonstrates excellent long-term patency and limb salvage rates.
  • Octogenarians undergoing CFAE experience increased perioperative mortality and major amputation risks.
  • Female gender, advanced age, and critical limb ischemia indicators are associated with poorer outcomes, while statin use may improve survival.
Abstract

Keywords:
Common femoral artery endarterectomyclaudicationcritical limb ischemianon-octogenariansoctogenariansperipheral arterial occlusion disease

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