Objective: Endarterectomy for peripheral arterial disease (PAD) in the common femoral artery (CFA) is a standard treatment and no paper regarding its long-term outcomes has been reported in Japan. The purpose of this study is to investigate the safety and durability of this surgery. Method: Consecutive 38 limbs in 37 patients who underwent endarterectomy in the CFA between April 1998 and December 2013 were enrolled. The primary endpoints were primary and assisted-primary patency, and the secondary endpoints were early complications after surgery, overall survival, and freedom from major amputation rates. Results: Technical success rate was 100% and the operative mortality was zero. There were five minor complications; and one required reoperation for serious bleeding on the day of endarterectomy. The primary and assisted-primary patency rate at 5 years was 97% and 100%, respectively. Overall survival and freedom from major amputation rates at 5 years was 90% and 70%, respectively. Conclusions: The safety and durability of endarterectomy for PAD in the CFA were promised. There is no doubt that this surgery is a standard treatment as a revascularization of this area.
We evaluated the extension of thrombus formed in the proximal stump of saphenous vein on day 6, 4 weeks, and 16 weeks after saphenous vein surgery from July 2013 to March 2014 (18 patients, 29 limbs, 31 stumps), using color Doppler echo. Extension of each thrombus was classified as endovenous heat-induced thrombosis (EHIT). Twenty-seven stumps (87.1%) formed thrombus and only four (12.9%) stumps remained without thrombus on day 6 after surgery. One stump formed thrombus EHIT class 2, and another one stump formed thrombus EHIT class 3. The rest of the 25 stumps formed thrombus EHIT class 1. No further extension of thrombus was found on 4 weeks and 16 weeks after surgery. The rate of thrombus formed in the proximal stump of saphenous vein after conventional surgery is relatively higher than that of after thermoablation techniques. Further study is needed to investigate adequate evaluation and appropriate therapy for stump thrombosis after varicose vein surgery.