Current role of thrombendarterectomy in chronic peripheral obstructive arteriopathy

BACKGROUND: The authors report the present indications for thromboendarterectomy (TEA) and the advantages it offers for the surgical treatment of steno-obstructive lesions of aortoiliac and femoro-popliteal regions. They illustrate this method and the necessary instruments and describe the technique in detail, for the good outcome of revascularization. METHODS: Then personal surgical experience in 46 patients during the period from January 1985 to December 1995, is reported. Epidemiological data (sex, average age, risk-factors, concomitant diseases), different types of surgical operations (TEA "open air", TEA "semiclosed", TEA in association with bypass), clinical and instrumental preoperating study, invasive or not, medical therapy during and after operation, immediate and remote check-up are then reported. RESULTS AND CONCLUSIONS: The results in terms of cumulative pervious vessel and salvage of the arm, compared with different stages of the disease and a 5 years- follow-up are reported. The effectiveness of TEA is confirmed in the symptomatic improvement and salvage of the arm, and the lower costs, when the indications and the accuracy of surgical technique are respected.