Ann Vasc Surg. 2026 Oct 16:S0890-5096(26)00723-5. doi: 10.1016/j.avsg.2026.10.005. Online ahead of print.
ABSTRACT
BACKGROUND: We sought to analyze patients who underwent femoral endarterectomy (FEA) for common femoral artery disease (CFAD) within the multicentre ARISTON registry aiming to compare the short-term and mid-term outcomes based on the use of different patch materials.
METHODS: The study is a secondary analysis of patients from a retrospective multicentre observational registry of FEA with patch angioplasty, extracted the ARISTON collaborative. The primary endpoint of the study was clinically-driven target lesion revascularization (CD-TLR).
RESULTS: A total of 547 patients undergoing FEA with patch angioplasty were included in the analysis and stratified according to the patch material into three groups: (i) prosthetic patch or PP (group A, n=249), (ii) bovine pericardium patch or BPP (group B, n=262), and (iii) great saphenous vein patch or GSVP (group C, n=36). Baseline characteristics differed significantly among groups. Technical success of the FEA procedure was achieved in all cases. Perioperative mortality was low and not significantly different between groups. Kaplan-Meier estimates of freedom from CD-TLR at two years were 86.2% (95% CI, 80.8-90.2%) in the PP group, 88.9% (95% CI, 83.1-92.8%) in the BPP group, and 69.8% (95% CI, 49.3-83.3%) in the GSVP group, with no statistically significant difference between groups (log-rank p=0.067). In multivariable analysis for freedom from CD-TLR, neither BPP (HR 0.78, 95% CI 0.47-1.29; P=0.330) nor GSVP (HR 1.99, 95% CI 0.95-4.17; P=0.069) was significantly associated with the outcome.
CONCLUSIONS: In this contemporary multicentre real-world experience, PP and BPP were the most used materials for patch reconstruction after FEA in patients with primary CFAD. Although the distribution of baseline risk factors was different between groups, mid-term freedom from CD-TLR was not significantly different between-groups. The findings describe contemporary surgeon-selected practice but do not determine the optimal allocation strategy, thereby reinforcing a clinically relevant message for contemporary vascular surgery: appropriate patient selection, meticulous technical execution, and comprehensive revascularization strategy are the key drivers of clinical outcomes, whereas patch material should likely be regarded as a complementary component within an individualized reconstructive framework.
PMID:42887735 | DOI:10.1016/j.avsg.2026.10.005