When the artery in the groin, the femoral artery, is stenosed or blocked, an operation can be used to remove the plaque from the artery in order to improve flow and circulation. The artery is close to the surface here under the skin, and therefore the surgical procedure is not too invasive. An alternative treatment would be angioplasty with a stent if required. This can be done with access to the arterial system from the opposite groin or arm to perform this.
Traditionally the long term results of surgery to remove the plaque when it is localised to the femoral artery have been better than angioplasty. However in certain patient's not suitable for surgery, and with improving technology, angioplasty is being used more frequently. Both treatments can therefore be used, your vascular surgical team will decide which is the best approach for you.
The surgical procedure can be performed under general or local anaesthetic. The plaque is removed from the artery. A patch is often used to repair the artery and avoid narrowing. Patient's will stay in hospital 1 or 2 nights following this procedure.
Major complications are not common, 2-3%. Bleeding requiring further surgery, blockage of the artery repair, and infection can occur.
The long-term result is often good, with the narrowing in the artery repaired for many years.
If there is also disease with narrowed or blocked arteries elswhere above the groin or further down the leg, the endarterectomy operation can be combined with angioplasty and stenting to treat these other areas at the same time. This combined or "hybrid" procedure is more common now and it achieves a better restoration of the circulation than the endarterectomy procedure alone.