{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T16:41:35Z","timestamp":1781714495190,"version":"3.54.5"},"reference-count":23,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,2,12]],"date-time":"2024-02-12T00:00:00Z","timestamp":1707696000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: The aim of this study was to evaluate the clinical outcomes of patients suffering from chronic limb-threatening ischemia (CLTI) and tissue loss treated with primary isolated femoral bifurcation endarterectomy (FBE) or with FBE combined with bypass surgery. Materials and Methods: This retrospective study was performed in a tertiary university-based care centre. Between January 2008 and December 2019, a prospectively collected database of patients suffering from CLTI and tissue loss and undergoing either primary FBE (group A) or FBE in combination with bypass surgery (group B) was analysed. Study endpoints were ulcer healing, primary and secondary patency rate, limb salvage, and survival. Results: In total, FBE was performed in 73 patients and FBE with bypass in 60 patients. Between both groups, there were no significant differences regarding demographic data or the Global Limb Anatomic Staging System (GLASS) grade III and IV of femoropopliteal lesions. After 3 years, ulcer healing could be achieved in 72% of FBE and in 75% of FBE with bypass patients. The primary patency rate was 95% and 91% for FBE and 83% and 80% for FBE with bypass after one and three years, respectively. The 3-year limb-salvage rate was 78% for FBE and 84% for FBE with bypass. The secondary patency rate after one and three years was 99% and 97% for FBE and 93% and 88% for FBE with bypass. Conclusions: FBE and FBE with bypass are equally effective for ulcer healing in cases of combined CFA and superficial femoral artery lesions. There was no significant difference between both groups regarding primary and secondary patency rates, limb salvage rates and ulcer healing. Isolated FBE could be an alternative strategy in patients with higher operative risk.<\/jats:p>","DOI":"10.3390\/medicina60020316","type":"journal-article","created":{"date-parts":[[2024,2,12]],"date-time":"2024-02-12T11:30:12Z","timestamp":1707737412000},"page":"316","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Using Isolated Femoral Bifurcation Endarterectomy or Combined with Bypass Surgery for Patients with Chronic Limb-Threatening Ischemia"],"prefix":"10.3390","volume":"60","author":[{"given":"Edin","family":"Ahmic","sequence":"first","affiliation":[{"name":"Department of Cardiovascular and Endovascular Surgery, Paracelsus Medical University Salzburg, M\u00fcllner Hauptstrasse 48, A-5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7696-1479","authenticated-orcid":false,"given":"Wolfgang","family":"Hitzl","sequence":"additional","affiliation":[{"name":"Research Office (Biostatistics), Paracelsus Medical University, M\u00fcllner Hauptstrasse 48, A-5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1514-7190","authenticated-orcid":false,"given":"Rainald","family":"Seitelberger","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Endovascular Surgery, Paracelsus Medical University Salzburg, M\u00fcllner Hauptstrasse 48, A-5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Linni","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Endovascular Surgery, Paracelsus Medical University Salzburg, M\u00fcllner Hauptstrasse 48, A-5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1016\/j.ejvs.2019.11.014","article-title":"Multiple peri-operative complications are associated with reduced long term amputation free survival following revascularisation for lower limb peripheral artery disease: A population based linked data study","volume":"59","author":"Aitken","year":"2020","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.ejvs.2019.05.006","article-title":"Global Vascular Guidelines on the Management of Chronic Limb-Threatening Ischemia","volume":"58","author":"Conte","year":"2019","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1177\/1708538118772682","article-title":"Common femoral artery endarterectomy in the age of endovascular therapy","volume":"26","author":"Elsherif","year":"2018","journal-title":"Vascular"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.jvs.2018.05.225","article-title":"Outcome of drug-eluting balloon angioplasty versus endarterectomy in common femoral artery occlusive disease","volume":"69","author":"Kuo","year":"2019","journal-title":"J. Vasc. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"S43","DOI":"10.1016\/S1078-5884(11)60014-2","article-title":"Chapter IV: Treatment of critical limb ischaemia","volume":"42","author":"Setacci","year":"2011","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1253\/circj.CJ-15-1177","article-title":"Clinical outcome of surgical endarterectomy for common femoral artery occlusive disease","volume":"80","author":"Kuma","year":"2016","journal-title":"Circ. J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.1016\/j.avsg.2015.05.005","article-title":"The Role of Common Femoral Artery Endarterectomy in the Endovascular Era","volume":"29","author":"Nishibe","year":"2015","journal-title":"Ann. Vasc. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.avsg.2018.03.046","article-title":"Infection Risk Following Common Femoral Artery Endarterectomy Versus a Hybrid Procedure","volume":"53","author":"Langenberg","year":"2018","journal-title":"Ann. Vasc. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1016\/j.jvs.2016.06.118","article-title":"Effect of adjunct femoral endarterectomy in lower extremity bypass on perioperative and 1-year outcomes","volume":"65","author":"Soden","year":"2017","journal-title":"J. Vasc. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1024\/0301-1526\/a000934","article-title":"Isolated femoral artery revascularisation with or without iliac inflow improvement\u2014A less invasive surgical option in critical limb ischemia","volume":"50","author":"Peters","year":"2021","journal-title":"Vasa"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1016\/j.avsg.2012.02.014","article-title":"Common femoral artery endarterectomy for lower-extremity ischemia: Evaluating the need for additional distal limb revascularization","volume":"26","author":"Malgor","year":"2012","journal-title":"Ann. Vasc. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/j.ejvs.2020.11.009","article-title":"Comparison of long term outcomes after endovascular treatment versus bypass surgery in chronic limb threatening ischaemia patients with long femoropopliteal lesions","volume":"61","author":"Zlatanovic","year":"2021","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1002\/ccd.26122","article-title":"An update on methods for revascularization and expansion of the TASC lesion classification to include below-the-knee arteries: A supplement to the inter-society consensus for the management of peripheral arterial disease (TASC II): The TASC steering committee","volume":"86","author":"Jaff","year":"2015","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1177\/1708538118786864","article-title":"Prognostic factors of ulcer healing and amputation-free survival in patients with critical limb ischemia","volume":"26","author":"Furuyama","year":"2018","journal-title":"Vascular"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/S0741-5214(97)70045-4","article-title":"Recommended standards for reports dealing with lower extremity ischemia: Revised version","volume":"26","author":"Rutherford","year":"1997","journal-title":"J. Vasc. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.surg.2009.08.004","article-title":"Common femoral artery endarterectomy for occlusive disease: An 8-year single-center prospective study","volume":"147","author":"Ballotta","year":"2010","journal-title":"Surgery"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"872","DOI":"10.1016\/j.jvs.2008.05.025","article-title":"Common femoral artery occlusive disease: Contemporary results following surgical endarterectomy","volume":"48","author":"Kang","year":"2008","journal-title":"J. Vasc. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1016\/j.ejvs.2022.04.002","article-title":"Non-reversed and reversed great saphenous vein graft configurations offer comparable early outcomes in patients undergoing infrainguinal bypass","volume":"63","author":"Chang","year":"2022","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/j.ejvs.2020.06.016","article-title":"Alternative venous conduits for below knee bypass in the absence of ipsilateral great saphenous vein","volume":"60","author":"Nierlich","year":"2020","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e19","DOI":"10.1016\/j.ejvs.2015.06.079","article-title":"Limited common femoral endarterectomy, & profundoplasty as an effective option in limb threatening ischaemia. A minimalistic approach in high-risk patients","volume":"50","author":"Tawfick","year":"2015","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1968","DOI":"10.1016\/j.jvs.2021.05.034","article-title":"Outcomes of bypass and endovascular interventions for advanced femoropopliteal disease in patients with premature peripheral artery disease","volume":"74","author":"Kim","year":"2021","journal-title":"J. Vasc. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1422","DOI":"10.1016\/j.jvs.2018.02.052","article-title":"The importance of the superficial and profunda femoris arteries in limb salvage following endovascular treatment of chronic aortoiliac occlusive disease","volume":"68","author":"Matielo","year":"2018","journal-title":"J. Vasc. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e2","DOI":"10.1016\/j.avsg.2021.05.028","article-title":"Pathophysiology of the profunda femoris artery in chronic lower limb ischemia","volume":"77","author":"Manenti","year":"2021","journal-title":"Ann. Vasc. 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