Endarterectomy as the procedure of choice for atherosclerotic occlusive lesions of the common femoral artery

Abstract

Isolated atherosclerotic lesions of the common femoral artery, though uncommon, are frequently associated with disabling peripheral ischemic symptoms when compared with similar lesions in the superficial femoral artery since claudication involves the thigh and calf and usually limits walking distance to less than one block. From 1969 to 1987, 29 patients underwent common femoral endarterectomy with vein patch angioplasty for symptoms of disabling claudication in 17, rest pain in 6 and ischemic ulceration in 6 patients. Endarterectomy was confined to the common femoral artery in 10 patients whereas endarterectomy was carried into either or both the deep or superficial femoral arteries in 19 patients. There was one immediate failure, secondary to residual disease in the outflow tract. All patients were discharged with patent reconstructions. Amputations were avoided in the 12 patients with advanced ischemic symptoms. Patients were followed long-term. Three patients were lost to follow-up with patent repairs to that time. There was one late occlusion. The cumulative patency rate 5 years postoperatively was 94 percent. The only complication was aneurysmal dilatation of the end-arterectomy site in one patient.