Proximal direct endarterectomy combined with simultaneous distal endovascular therapy for chronic full-length occlusion of the superficial femoral artery in elderly patients
| Autor: | Mitsuyuki Nakayama, Fumikazu Sakamoto |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
critical limb ischemia
Male medicine.medical_specialty medicine.medical_treatment lcsh:Surgery Endarterectomy superficial femoral artery Endovascular therapy elderly hybrid revascularization Peripheral Arterial Disease Occlusion medicine Deep Femoral Artery Humans Aged Aged 80 and over Superficial femoral artery business.industry Critical limb ischemia lcsh:RD1-811 Combined Modality Therapy Surgery Femoral Artery Ostium Treatment Outcome ostium Chronic Disease Feasibility Studies Radiology medicine.symptom business Angioplasty Balloon Major amputation Follow-Up Studies |
| Zdroj: | Scipedia Open Access Scipedia SL Asian Journal of Surgery, Vol 36, Iss 3, Pp 104-110 (2013) |
| ISSN: | 0219-3108 |
| Popis: | Summary Background and purpose The most proximal ostial site of the chronic occlusive superficial femoral artery is not suitable for ballooning or stenting because the deep femoral artery may be occluded by these procedures. Thus, the feasibility of performing an open endarterectomy for the occluded ostium of the superficial femoral arteries combined with an endovascular therapy for the remaining distal site was evaluated. Methods Eleven critically ischemic limbs in 10 elderly patients with poor general health were enrolled. They had full-length occlusion of the superficial femoral artery involving its ostium. The ostial site was managed with an open endarterectomy followed by endovascular therapy for the remaining distal site. Results All procedures were successfully performed. All patients experienced pain relief, and the wounds healed. During the follow-up observation period (average: 23.9 ± 14.7 months), nine patients died. None of the patients, including those who had lost patency of the superficial femoral artery, received major amputation. Conclusion Elderly patients, including those who were in terminal stage, were able to withstand the operation, and their postoperative quality of life was not compromised. Although the patency following the surgery was limited, sparing the deep femoral artery could either prevent or delay the recurrence of critical limb ischemia. |
| Databáze: | OpenAIRE |
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