Significance of Outflow Obstruction After Femoropopliteal Endarterectomy

Abstract

ARTERIAL insufficiency caused by atherosclerotic occlusive lesions of the superficial femoral and popliteal arteries is one of the most challenging problems in vascular surgery. Failures of reconstructive techniques, either at the time of operation or during the postoperative period, are distinctly more common than in similar operations at other sites. Postoperative occlusion has been variously attributed to the type of operation, technical errors during operation, inadequate outflow, or the presence of distal occlusive lesions which reduce arterial outflow. Of the two methods currently favored for femoropopliteal reconstruction, endarterectomy and saphenous vein bypass, the venous bypass technique has given some-what better long-term results. However, the success of either operation is largely influenced by the degree and rate of progression of distal occlusive lesions and the technical excellence of the reconstructive procedure. The present report is an evaluation of the factors influencing prognosis following femoropopliteal endarterectomy, with particular emphasis upon the morphology