Name of the Procedure:

Thromboendarterectomy of the Deep Femoral Artery Common Name(s): Profunda Femoral Thromboendarterectomy, Deep Femoral Artery Surgery

Summary

Thromboendarterectomy of the deep femoral artery is a surgical procedure to remove blood clots and plaque from the deep femoral artery (profunda femoris). If necessary, a patch graft is applied to repair the artery.

Purpose

Addresses: Blockage or narrowing of the deep femoral artery. Goals: Restore proper blood flow, alleviate symptoms like pain and cramping, and prevent tissue damage in the leg.

Indications

• Symptoms: Severe leg pain, cramping, or difficulty walking due to poor blood circulation.
• Conditions: Peripheral artery disease (PAD), deep femoral artery occlusion.
• Patient Criteria: Patients who have not responded to medication or lifestyle changes, or those with severe arterial blockages.

Preparation

Instructions:

• Fasting typically required for 8-12 hours before the procedure.
• Discontinuation or adjustment of certain medications as advised by your doctor. Diagnostic Tests:
• Blood tests, imaging studies (e.g., duplex ultrasound, CT angiography) to assess the blockage.

Procedure Description

Steps:

1. Administer anesthesia—general or regional, depending on the patient's condition.
2. Make an incision in the thigh to access the deep femoral artery.
3. Remove the clot and plaque from the artery.
4. If required, apply a patch graft to strengthen the artery wall.
5. Close the incision with sutures or staples. Tools/Equipment: Surgical instruments, patch graft material. Anesthesia: General or regional anesthesia.

Duration

Typically, 2-3 hours.

Setting

Performed in a hospital operating room.

Personnel

Surgeons: Vascular surgeon. Others: Anesthesiologists, surgical nurses, scrub techs.

Risks and Complications

Risks:

• Infection at the surgical site
• Bleeding or hematoma
• Blood clots
• Artery damage or re-narrowing of the artery
• Anesthesia-related complications Complications: Managed with medication or additional surgical intervention if necessary.

Benefits

Expected Benefits:

• Improved blood flow and reduced symptoms.
• Increased ability to walk longer distances without pain. Realization Time: Benefits often realized within days to weeks after the procedure.

Recovery

Post-Procedure Care:

• Hospital stay of 1-3 days for monitoring.
• Pain management with prescribed medications.
• Avoid strenuous activities for several weeks.
• Follow-up appointments for wound checks and activity guidance. Recovery Time:
• Full recovery typically takes several weeks to a few months.

Alternatives

Other Treatment Options:

• Angioplasty with or without stent placement.
• Medication management and lifestyle modifications. Comparison:
• Angioplasty is less invasive but may not be as effective for severe blockages.
• Medications and lifestyle changes work better for less severe cases.

Patient Experience

During Procedure: Patients will be under anesthesia and should not feel pain during the procedure. After Procedure:

• Some discomfort and swelling at the incision site.
• Pain managed with medications.
• Gradual improvement in symptoms and mobility.