ABSTRACT
Prosthetic grafts of various types have been the only alternative to revascularization of the leg when the saphenous vein is not used. Our complication rate with prosthetic grafts has led us to search for a different alternative. Long-segment endarterectomy of the iliac, femoral, and popliteal arteries has become a realistic procedure with the use of the Hall oscillating endarterectomy instrument. Although it may be difficult technically and more time-consuming than a usual bypass graft procedure, the results have been good. Fifty-eight procedures have been reported in 53 patients. Eighty-eight percent of the procedures were performed for limb salvage with a 5 percent operative mortality rate. There was an overall cumulative limb salvage rate of 88 percent. The cumulative patency rate with a follow-up of 5 to 24 months was 55 percent. Special emphasis has been placed on technical considerations and pitfalls of the procedure. The procedure is versatile and can be used in combination with a variety of both inflow and outflow procedures.
