Abstract
Segmental occlusive disease though limited to the popliteal artery gives rise to significant ischemic symptoms such that surgical treatment is indicated. Endarterectomy with vein angioplasty was the primary procedure in 76 patients (79 limbs) over the past 15 years. Augmentive lumbar sympathectomy was performed in 30 patients. Endarterectomy restoration was successful in 73 patients (76 limbs). Acute postoperative thrombosis occurred in six limbs, four were restored, one survived, one underwent delayed amputation. Long term failures developed in 18 limbs, four were restored, 11 survived without further treatment, and three were amputated. All limbs were classified according to stages of outflow obstruction and extent of endarterectomy; however, there was no meaningful pattern of correlation with failures except to note that amputations occurred only in advanced stage III obstructions. Thirty-two patients (43%) were restudied by arteriography. Cumulative patency rate for 79 limbs at risk at five years was 75.6%, at ten years, 58.5%. Restoration of popliteal patency can be accomplished by endarterectomy with results comparable to femoral-popliteal saphenous vein graft for more proximal lesions. Endarterectomy affords the advantage that a bypass procedure can still be performed in most failures as the long saphenous vein, not sacrificed initially, is still available.
Full text
PDF





Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- CUTLER S. J., EDERER F. Maximum utilization of the life table method in analyzing survival. J Chronic Dis. 1958 Dec;8(6):699–712. doi: 10.1016/0021-9681(58)90126-7. [DOI] [PubMed] [Google Scholar]
- Catlin R., Movius H. J., 2nd, Gaspar M. R. Femoropopliteal thromboendarterectomy. Technic and results. Am J Surg. 1966 Aug;112(2):156–161. doi: 10.1016/0002-9610(66)90003-1. [DOI] [PubMed] [Google Scholar]
- DE BAKEY M. E., CRAWFORD E. S., MORRIS G. C., Jr, COOLEY D. A. Patch graft angioplasty in vascular surgery. J Cardiovasc Surg (Torino) 1962 Apr;3:106–141. [PubMed] [Google Scholar]
- DOS SANTOSJ LATE RESULTS OF RECONSTRUCTIVE ARTERIAL SURGERY; RESTORATION --DISOBLITERATION--REPLACEMENT WITH THE ESTABLISHMENT OF SOME OPERATIVE PRINCIPLES. J Cardiovasc Surg (Torino) 1964 Nov-Dec;5:445–462. [PubMed] [Google Scholar]
- Darling R. C., Linton R. R. Durability of femoropopliteal reconstructions. Endarterectomy versus vein bypass grafts. Am J Surg. 1972 Apr;123(4):472–479. doi: 10.1016/0002-9610(72)90202-4. [DOI] [PubMed] [Google Scholar]
- DeWeese J. A., Barner H. B., Mahoney E. B., Rob C. G. Autogenous venous bypass grafts and thromboendarterectomies for atherosclerotic lesions of the femoropopliteal arteries. Ann Surg. 1966 Feb;163(2):205–214. doi: 10.1097/00000658-196602000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Imparato A. M., Bracco A., Kim G. E. Comparisons of three technics for femoral-popliteal arterial reconstruction, 1. vein bypass, 2. open endarterectomy, 3. semiclosed endarterectomy. Ann Surg. 1973 Mar;177(3):375–380. doi: 10.1097/00000658-197303000-00022. [DOI] [PMC free article] [PubMed] [Google Scholar]
- McAllister F. F. The fate of patients with intermittent claudication managed nonoperatively. Am J Surg. 1976 Nov;132(5):593–595. doi: 10.1016/0002-9610(76)90351-2. [DOI] [PubMed] [Google Scholar]
- Ross R., Glomset J. A. The pathogenesis of atherosclerosis (first of two parts). N Engl J Med. 1976 Aug 12;295(7):369–377. doi: 10.1056/NEJM197608122950707. [DOI] [PubMed] [Google Scholar]
- Sapirstein W., Bottomley M. G., Baker C. B. Thromboendarterectomy in the treatment of femoropopliteal occlusions. Can J Surg. 1966 Jul;9(3):231–236. [PubMed] [Google Scholar]
- WYLIE E. J., BINKLEY F. M., ALBO R. J. FEMOROPOPLITEAL ENDARTERECTOMY: OPERATIVE MODIFICATIONS AND CONSIDERATION OF EFFECTS OF OUTFLOW LESIONS. Am J Surg. 1964 Aug;108:215–223. doi: 10.1016/0002-9610(64)90012-1. [DOI] [PubMed] [Google Scholar]
- WYLIE E. J., BINKLEY F. M., ALBO R. J. FEMOROPOPLITEAL ENDARTERECTOMY: OPERATIVE MODIFICATIONS AND CONSIDERATION OF EFFECTS OF OUTFLOW LESIONS. Am J Surg. 1964 Aug;108:215–223. doi: 10.1016/0002-9610(64)90012-1. [DOI] [PubMed] [Google Scholar]