Femoral Endarterectomy and Patching Surgery
When the most important disease is localized to the common femoral artery (artery in the groin) the surgical procedure known as an endarterectomy is often useful. In this operation the femoral artery and its two main branches are exposed via an incision in the groin with information form the angiogram and also by palpating the artery the surgeon is able to put clamps above and below the atheroma which is causing the impirement of blood supply.
With the artery controlled the surgeons can then open up the artery and remove the atheromatous plaque. The artery is essentially "rebored". The opening in the artery (arteriotomy) is usually closed by sewing in a patch of material as if it was closed by sewing the two edges directly together a new narrowing would occur in this place.
The material used for this patch varies from surgeon to surgeon. A piece of vein can be used as the patch, many surgeons now use bovine pericardial patch to close the artery. This patch is specially treated tissue taken from the membrane that surrounds the cow’s heart. It has been proven to be a very good patch and resists infection (which is a very serious complication).
Although the common femoral artery is the most common place, an endarterectomy is performed; the same principles can be applied to any artery where there is localized atheroma.
Complications of this procedure most commonly are related to the wound. In the groin there are many lymphatic channels taking lymph flow back to the heart. If these become overly disrupted then the lymph fluid can leak and cause problems with wound healing and discharge.