Zatykó Dóra Zoé, Pomozi Enikő, Pál Dániel, Kovács Tamás, Szeberin Zoltán
Department of Vascular and Endovascular Surgery, Semmelweis University Heart and Vascular Centre, 1122 Budapest, Hungary.
J Clin Med. 2025 May 30;14(11):3852. doi: 10.3390/jcm14113852.
Common femoral endarterectomy (CFE) is one of the most frequent open arterial surgical procedures. The ideal material to close the arteriotomy is equivocal. This study aims to evaluate the efficacy and safety of bovine pericardium patch (BPP) utilization in femoral artery bifurcation endarterectomy (FE). : A single-center, retrospective study was conducted, involving 200 consecutive FE procedures performed between November 2019 and December 2022. Clinical data, including demographics, comorbidities, surgical details, and outcomes, were collected from institutional records. The primary endpoints were overall survival, reintervention-free survival, and amputation-free survival. Secondary endpoints included the incidence of surgical site infection (SSI) and its associated risk factors. Logistic regression models were used to identify predictors of SSI, adjusting for confounders such as age, smoking, comorbidities, and bacterial colonization. : The median age of the cohort was 68 (SD ± 9.70) years, and 66% were male. The median follow-up period was 1010 (SD ± 471.47) days. Thirty-day survival was 91%, and 2 year survival was 69.3%, with cardiovascular events and cancer being the leading causes of death. Reintervention-free survival was 94.7% at 30 days and 77.5% at 2 years, while amputation-free survival was 94.3% at 30 days and 87.4% at 2 years. SSI requiring surgery occurred in 16% of patients, with a higher risk observed in patients with critical limb ischemia (CLI) compared to those with claudication. The presence of pathogens such as MRSA, , and (OR 16.1, < 0.001) was significantly associated with SSI. Previous groin surgery did not affect SSI incidence. : BPP utilization in FE provides favorable patency and survival outcomes, even in a high-risk patient population with significant comorbidities. CLI and bacterial colonization increased the risk of SSI. Perioperative infection prevention strategies and management of systemic comorbidities are essential to improve patient outcomes.
股总动脉内膜切除术（CFE）是最常见的开放性动脉外科手术之一。用于闭合动脉切开术的理想材料尚无定论。本研究旨在评估牛心包补片（BPP）在股动脉分叉内膜切除术（FE）中应用的有效性和安全性。：进行了一项单中心回顾性研究，纳入了2019年11月至2022年12月期间连续进行的200例FE手术。从机构记录中收集临床数据，包括人口统计学、合并症、手术细节和结果。主要终点是总生存率、无再次干预生存率和无截肢生存率。次要终点包括手术部位感染（SSI）的发生率及其相关危险因素。使用逻辑回归模型确定SSI的预测因素，并对年龄、吸烟、合并症和细菌定植等混杂因素进行调整。：队列的中位年龄为68（标准差±9.70）岁，66%为男性。中位随访期为1010（标准差±471.47）天。30天生存率为91%，2年生存率为69.3%，心血管事件和癌症是主要死亡原因。30天时无再次干预生存率为94.7%，2年时为77.5%，而30天时无截肢生存率为94.3%，2年时为87.4%。16%的患者发生了需要手术的SSI，与间歇性跛行患者相比，严重肢体缺血（CLI）患者的风险更高。耐甲氧西林金黄色葡萄球菌等病原体的存在与SSI显著相关（比值比16.1，P<0.001）。既往腹股沟手术不影响SSI发生率。：即使在合并症严重的高危患者群体中，FE中使用BPP也能提供良好的通畅率和生存结果。CLI和细菌定植增加了SSI的风险。围手术期感染预防策略和全身性合并症的管理对于改善患者预后至关重要。
