An Exact Match Outcome Analysis of Two Different Patches During Femoral Endarterectomy

BACKGROUND: To analyze the outcomes of two different patch materials during femoral endarterectomies (FEA). METHODS: It is a ingle center, observational, retrospective cohort study. We identified all patients operated between January 1st, 2016-December 31st, 2023. An exact match analysis was used to identify two groups based on the type of patch: pericardial, and dacron. The primary outcomes were the freedom from patch-related complications and/or reoperations during follow-up. Secondary outcomes were the perioperative complication rate and limb salvage rate. RESULTS: We analyzed 275 patch reconstructions: 139 (50.5%) with pericardial patch, and 136 (49.5%) with dacron patch. There was no difference between the two groups either for the duration of intervention [190 (IQR, 130-262) vs. 172 (IQR, 118.7-257); p = 0.131] or the blood loss [250 (IQR, 150-500) vs. 200 (IQR, 100-500); p = 0.130]. We observed no intraprocedural deaths and only 1 (0.4%) in-hospital death. Overall, we observed 87 (31.3%) complications of which 35 (12.7%) were major. The median follow-up was 32 (IQR, 16-58) months. Overall, estimated cumulative survival was 82% ± 2 at 12 months (95% CI: 79.6-85.2) and 52% ± 3 at 60 months (95% CI: 45.3-58.9) with no difference between the two groups (p = 0.282). We encountered 19 (6.9%) patch-related reinterventions: restenosis in 10 (52.6%) and pseudoaneurysm/infection in 9 (47.4). %) cases. Freedom from patch-related reoperation was estimated 92% ± 9 at 60 months (95% CI: 87.4-94.9) without significant differences between the two groups (p = 0.810). Cox regression did not identify any predictive factors. The need for patch-related reintervention was not associated with an increased mortality (p = 0.972) or risk of major amputation was observed (p = 0.080). CONCLUSIONS: Femoral endarterectomy is safe, and mid-term outcomes are independent of the patch material used for its reconstruction.