Abramov I S, Maĭtesian D A, Lazarian T A, Baldin V L, Verigo A V, Eremenko A G, Papoian S A
Angiol Sosud Khir. 2014;20(4):147-51.
To compare the results of semiclosed retrograde loop endarterectomy from the superficial femoral artery (SFA) and proximal femoropopliteal bypass grafting (FPBG) with a synthetic prosthesis.
From 2007 to 2011, at the Department of Vascular Surgery of Municipal Clinical Hospital No 15 named after O.M. Filatov we operated on a total of 97 patients with occlusive and stenotic lesions of the femoropopliteal segment, with 83 (86%) of them being men. The mean age of the patients was 62.7 ± 8.9 years. By the degree of chronic ischaemia the patients were subdivided according to the Fontain-Pokrovsky classification as follows: 52 (53.6%) patients had stage 2B ischaemia, 22 (22.7%) patients presented with stage 3, and 14 (14.4%) patients had stage 4. Nine (9.3%) patients were diagnosed with symptoms of acute ischaemia. Depending on the operative treatment performed, the patients were subdivided into two groups: Group I (n=56) comprising patients subjected to FPBG above the knee-joint fissure and Group II (n=41) consisting of those who underwent loop endarterectomy from the SFA.
Technical success was obtained in 97 (100%) patients. After the operation the average ankle-brachial index (ABI) amounted to 0.87 ± 0.22 in Group I and 0.83 ± 0.22 in Group II. One (1.8%) patient from Group I developed shunt thrombosis successfully treated by thrombectomy. In Group II after surgery we also observed 1 thrombosis (2.4%) of the desobliterated superficial femoral artery, treated by thrombectomy from the SFA. The remote results were followed up during 4-7 years. Primary patency in the group of patients undergoing FPBG amounted after 1 and 2 years to 73.1% and 63.2% (p<0.005), and after 3 and 4 years to 34.1% and 30.7% (p>0.05). In the group of patients after loop EAE from the SFA 1-, 2-, 3- and 4-year primary patency amounted to 92.1%, 74.6% (p<0.05) and 63.1%, 58.9% (p>0.05), respectively.
Semiclosed retrograde loop endarterectomy (EAE) demonstrated better results both in the immediate and remote postoperative periods as compared with femoropopliteal proximal bypass grafting using a synthetic prosthesis.
