Clinical Outcomes of Common Femoral Thromboendarterectomy for Lower-Extremity Arterial Disease: Differences Between Chronic Limb-Threatening Ischemia and Intermittent Claudication
Purpose: This study retrospectively evaluated the mid-term outcomes of thromboendarterectomy (TEA) for common femoral artery (CFA) disease in a Japanese cohort by comparing patients with chronic limb-threatening ischemia (CLTI) and intermittent claudication (IC). Materials and Methods : Sixty-three...
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Medrang
2025-07-01
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| Series: | Vascular Specialist International |
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| Online Access: | http://www.vsijournal.org/journal/view.html?doi=10.5758/vsi.250027 |
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| author | Takahiro Mizoguchi Takasuke Harada Yuriko Takeuchi Makoto Samura Hiroshi Kurazumi Ryo Suzuki Kotaro Suehiro Kimikazu Hamano |
| author_facet | Takahiro Mizoguchi Takasuke Harada Yuriko Takeuchi Makoto Samura Hiroshi Kurazumi Ryo Suzuki Kotaro Suehiro Kimikazu Hamano |
| author_sort | Takahiro Mizoguchi |
| collection | DOAJ |
| description | Purpose: This study retrospectively evaluated the mid-term outcomes of thromboendarterectomy (TEA) for common femoral artery (CFA) disease in a Japanese cohort by comparing patients with chronic limb-threatening ischemia (CLTI) and intermittent claudication (IC). Materials and Methods : Sixty-three TEA procedures performed between 2011 and 2024 were analyzed. The primary endpoints focused on procedure-related outcomes such as patency and limb salvage, whereas overall survival was assessed as a key secondary outcome. The patients were divided into the CLTI (n=20) and IC (n=43) groups; the anesthesia type, additional revascularization, blood loss, hospital stay, complications, and survival were compared. Multivariable Cox regression analysis was performed to identify independent predictors of mortality. Results : Patients with CLTI had higher rates of local anesthesia, additional revascularization (all performed concomitantly), greater blood loss, and longer hospital stays. Despite the 100% technical success in both groups, 30-day mortality and complications occurred only in the CLTI group. Kaplan-Meier analysis showed similar patency and limb salvage rates between groups, whereas survival rates were significantly lower in patients with CLTI (P=0.037). Multivariable analysis revealed that CLTI itself was not an independent predictor of mortality; rather, a worse systemic status (e.g., higher American Society of Anesthesiologists classification) showed a trend toward poorer outcomes (P=0.051). No significant differences were found between the patch types. Conclusion : TEA provides effective mid-term outcomes in patients with CFA disease, particularly those with IC. Although patients with CLTI show poorer survival, this appears to be driven more by systemic comorbidities than by the limb status itself. Careful preoperative assessment and holistic management of general health are essential to optimize outcomes, particularly in high-risk populations. |
| format | Article |
| id | doaj-art-78e63eedeb574088b7d9bc0b648706e0 |
| institution | DOAJ |
| issn | 2288-7970 2288-7989 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Medrang |
| record_format | Article |
| series | Vascular Specialist International |
| spelling | doaj-art-78e63eedeb574088b7d9bc0b648706e02025-08-20T02:46:40ZengMedrangVascular Specialist International2288-79702288-79892025-07-014110.5758/vsi.250027vsi.250027Clinical Outcomes of Common Femoral Thromboendarterectomy for Lower-Extremity Arterial Disease: Differences Between Chronic Limb-Threatening Ischemia and Intermittent ClaudicationTakahiro Mizoguchi0Takasuke Harada1Yuriko Takeuchi2Makoto Samura3Hiroshi Kurazumi4Ryo Suzuki5Kotaro Suehiro6Kimikazu Hamano7Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi, JapanDivision of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi, JapanDivision of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi, JapanDivision of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi, JapanDivision of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi, JapanDivision of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi, JapanDivision of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi, JapanDivision of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi, JapanPurpose: This study retrospectively evaluated the mid-term outcomes of thromboendarterectomy (TEA) for common femoral artery (CFA) disease in a Japanese cohort by comparing patients with chronic limb-threatening ischemia (CLTI) and intermittent claudication (IC). Materials and Methods : Sixty-three TEA procedures performed between 2011 and 2024 were analyzed. The primary endpoints focused on procedure-related outcomes such as patency and limb salvage, whereas overall survival was assessed as a key secondary outcome. The patients were divided into the CLTI (n=20) and IC (n=43) groups; the anesthesia type, additional revascularization, blood loss, hospital stay, complications, and survival were compared. Multivariable Cox regression analysis was performed to identify independent predictors of mortality. Results : Patients with CLTI had higher rates of local anesthesia, additional revascularization (all performed concomitantly), greater blood loss, and longer hospital stays. Despite the 100% technical success in both groups, 30-day mortality and complications occurred only in the CLTI group. Kaplan-Meier analysis showed similar patency and limb salvage rates between groups, whereas survival rates were significantly lower in patients with CLTI (P=0.037). Multivariable analysis revealed that CLTI itself was not an independent predictor of mortality; rather, a worse systemic status (e.g., higher American Society of Anesthesiologists classification) showed a trend toward poorer outcomes (P=0.051). No significant differences were found between the patch types. Conclusion : TEA provides effective mid-term outcomes in patients with CFA disease, particularly those with IC. Although patients with CLTI show poorer survival, this appears to be driven more by systemic comorbidities than by the limb status itself. Careful preoperative assessment and holistic management of general health are essential to optimize outcomes, particularly in high-risk populations.http://www.vsijournal.org/journal/view.html?doi=10.5758/vsi.250027peripheral arterial diseasethromboendarterectomypatch angioplastybovine pericardiumfemoral artery |
| spellingShingle | Takahiro Mizoguchi Takasuke Harada Yuriko Takeuchi Makoto Samura Hiroshi Kurazumi Ryo Suzuki Kotaro Suehiro Kimikazu Hamano Clinical Outcomes of Common Femoral Thromboendarterectomy for Lower-Extremity Arterial Disease: Differences Between Chronic Limb-Threatening Ischemia and Intermittent Claudication Vascular Specialist International peripheral arterial disease thromboendarterectomy patch angioplasty bovine pericardium femoral artery |
| title | Clinical Outcomes of Common Femoral Thromboendarterectomy for Lower-Extremity Arterial Disease: Differences Between Chronic Limb-Threatening Ischemia and Intermittent Claudication |
| title_full | Clinical Outcomes of Common Femoral Thromboendarterectomy for Lower-Extremity Arterial Disease: Differences Between Chronic Limb-Threatening Ischemia and Intermittent Claudication |
| title_fullStr | Clinical Outcomes of Common Femoral Thromboendarterectomy for Lower-Extremity Arterial Disease: Differences Between Chronic Limb-Threatening Ischemia and Intermittent Claudication |
| title_full_unstemmed | Clinical Outcomes of Common Femoral Thromboendarterectomy for Lower-Extremity Arterial Disease: Differences Between Chronic Limb-Threatening Ischemia and Intermittent Claudication |
| title_short | Clinical Outcomes of Common Femoral Thromboendarterectomy for Lower-Extremity Arterial Disease: Differences Between Chronic Limb-Threatening Ischemia and Intermittent Claudication |
| title_sort | clinical outcomes of common femoral thromboendarterectomy for lower extremity arterial disease differences between chronic limb threatening ischemia and intermittent claudication |
| topic | peripheral arterial disease thromboendarterectomy patch angioplasty bovine pericardium femoral artery |
| url | http://www.vsijournal.org/journal/view.html?doi=10.5758/vsi.250027 |
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