Surgical-site infection is a major complication following endarterectomy of the common femoral artery. The aim of this single-center study was to determine risk factors for surgical-site infection after endarterectomy of the common femoral artery and especially the possible association between patch type (venous, bovine, or prosthetic) and the occurrence of groin infection. Retrospectively 140 patients who underwent an endarterectomy of the common femoral artery between 2003 and 2006 were reviewed. About 20 patients (14%) suffered from a surgical-site infection (12 superficial and 8 deep, of which 2 with involvement of the patch). All infections occurred within 30 days postoperatively. There was no statistically significant difference between type of patch and surgical-site infection. However, using multivariate analysis, previous arterial surgery in the groin (P = .013) and a wound drain left postoperatively (P = .016) were independent variables for the development of a surgical-site infection after endarterectomy of the common femoral artery.

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Plaque composition of the CFA and SFA differs. Furthermore, the dissection of a fibrous collagen-rich plaque is an independent predictive variable for restenosis after endarterectomy of the CFA and SFA.

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Multiple risk factors have been associated with progression of atherosclerosis. To identify the individual patient who is at risk for disruption of a vulnerable plaque, leading to a cardiovascular event, remains a major challenge. Current screening methods, based on traditional risk factors, do not allow risk stratification on an individual level. The discovery of new biomarkers would aid in identifying specific patient groups at risk for adverse cardiovascular events due to atherosclerotic disease progression. The current definition of the vulnerable plaque, e.g. atheromatous inflammatory plaque with a thin fibrous cap, has been based on cross-sectional post-mortem studies. The predictive value of these histological characteristics of the vulnerable plaque is likely to be low, because they are also frequently observed at multiple locations in symptomatic and asymptomatic patients. The Athero-express study follows a new concept to search for the atherosclerotic patient who may suffer from adverse events. In this study, we investigate the predictive value of local plaque composition for adverse events in other vascular territories, regarding the plaque as a concentrated expression of this systemic disease. First results from this longitudinal biobank study show that the local plaque hides strong predictive value for cardiovascular events elsewhere in the vascular tree. Longitudinal biobank studies will facilitate the identification of novel local plaque markers. The search for the plaque protein signature that is predictive for adverse events might enable patient stratification that will allow individualized tailor made medicine and subsequently guide the choice for therapeutic interventions.