Hybrid Revascularization Using Silverhawk Atherectomy and Infrapopliteal Bypass for Limb Salvage

Functional outcome after femoral endarterectomy: A single-centre experience

OBJECTIVE

To assess limb salvage and functional outcome in patients who underwent femoral endarterectomy (FE).

METHODS

A single-centre, retrospective analysis of all patients undergoing FE in the past four years.

RESULTS

FE was performed on 30 patients (32 symptomatic legs) to treat gangrene (n=5), pain at rest (n=7) and incapacitating intermittent claudication (n=20). Patients had a mean age of 76.2 years. Twenty-three FEs were performed electively and nine were emergency procedures. Twenty-two patients were operated on under general anesthesia, five under local anesthesia and three under spinal/epidural anesthesia. Forty-six per cent of the patients underwent a simultaneous revascularization procedure (33% profundaplasty, 3% femoral-femoral cross-over, 3% femoral-popliteal and 3% aorto-bifemoral bypass). Overall patency rate and limb salvage rate was 80% and 74%, respectively, at mean follow-up of 25 months. Early mortality was 6% and morbidity was 24%. Among the living patients, 88% were happy with their quality of life and rated the procedure excellent, 6% rated the procedure as good and 6% rated the procedure as bad.

CONCLUSION

The functional outcome of FE is very favourable, either as a primary or adjunctive procedure where angioplasty is not possible. FE can be performed under locoregional anesthesia, which is potentially suitable in elderly patients to avoid major amputation and its associated sequelae.