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ORIGINAL RESEARCH article

Front. Surg.
Sec. Vascular Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1445846
This article is part of the Research Topic Diagnosis and Treatment for Arteriosclerosis and Thrombosis View all 4 articles

Impact of Open Femoral Endarterectomy in Treating Multilevel Iliac and Common Femoral Artery Occlusive Disease

Provisionally accepted
Suehyun Park Suehyun Park Taewhan Koo Taewhan Koo Deokbi Hwang Deokbi Hwang Woo-Sung Yun Woo-Sung Yun Seung Huh Seung Huh Hyung-Kee Kim Hyung-Kee Kim *
  • Kyungpook National University Hospital, Daegu, Republic of Korea

The final, formatted version of the article will be published soon.

    Purpose: This study aimed to evaluate the impact of femoral endarterectomy (FE) in treating multilevel iliac and common femoral artery occlusive disease.: From January 2013 to December 2022, 106 limbs in 103 patients with multilevel arterial occlusive disease underwent open FE and iliac angioplasty (FEIA) with or without infrainguinal revascularization. The primary outcome assessment was the changes in TransAtlantic Inter-Society Consensus (TASC) II classification during operation; the secondary outcomes included the primary patency (PP) and secondary patency (SP) of FEIA. The risk factors for PP loss were evaluated. Results: Of the 103 patients, 91 were male. A total of 56 limbs were treated for chronic limbthreatening ischemia (CLTI), and 61 limbs underwent infrainguinal revascularization. Preoperative aortoiliac occlusive disease (AIOD) was classified as TASC II C in 65 (61%) limbs and D in 41 limbs. During operation, 19 limbs received additional thrombectomy for subacute or chronic thrombus component. Overall, FE and additional thrombectomy reduced the TASC II classification of AIOD from complex lesions (TASC II C/D) to simple lesions (B or lesser) in 101 ( 95%) of 106 limbs. Three early mortalities (2.8%, two acute myocardial infarctions, one pneumonia) were recorded. The PP and SP of FEIA were 89% and 96% at 1 year, 80% and 94% at 3 years, and 77% and 94% at 5 years, respectively. The severity of iliac and common femoral artery disease was not associated with PP loss of FEIA.Conclusions: Despite the challenging nature of initially classified TASC II C/D lesions, our findings highlight the effectiveness of FE in reducing TASC II classification and durable patency achieved with FEIA. Hybrid FEIA could be a viable primary treatment option, particularly for the lesions featuring severe iliac and common femoral artery disease.

    Keywords: SH, HK. Analysis and interpretation: SP, DH, WY, HK. Data collection: SP, TK, DH, HK. Writing the article: SP, TK, HK. Critical revision of the article: WY, HK, SH SP, DH, HK. Obtained funding: HK. Overall responsibility: HK Peripheral arterial disease, Ischemia, treatment outcome, Endarterectomy, Stent Impact of Open Femoral Endarterectomy in Treating Multilevel Iliac and Common Femoral Artery Occlusive Disease

    Received: 08 Jun 2024; Accepted: 02 Jan 2025.

    Copyright: © 2025 Park, Koo, Hwang, Yun, Huh and Kim. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Hyung-Kee Kim, Kyungpook National University Hospital, Daegu, Republic of Korea

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