Radical Open Femoral-Popliteal Endarterectomy with Vein Onlay Graft

During the past decade considerable progress has been made in the surgical management of arteriosclerosis obliterans of the lower extremity. However, while the results of operative treatment of the aortoiliac segment have been encouraging, the degree of success in the femoral-popliteal region has been discouraging. The small caliber of the vessels, as well as the reduced rate of arterial inflow and outflow, are probably the principal reasons for failure. Nevertheless, the search continues for more satisfactory methods of dealing with this area of arterial insufficiency. The present study has been stimulated by the recognition of such needs, and our results to date appear sufficiently encouraging to justify this preliminary report.

The first thromboendarterectomy was performed by dos Santos in 1946.¹ Sporadic reports of successful thromboendarterectomy appeared during the next 5 years; however, these were limited primarily to the larger vessels of the aortoiliac region. In 1952 Wylie² reported