Short- and Mid-Term Outcomes of Bovine Pericardial Patch vs. Saphenous Vein Patch in Femoral Endarterectomy

Objectives: Femoral endarterectomy often requires patch angioplasty, and saphenous vein patch (SVP) was the standard. However, bovine pericardial patch (BPP) provides potential advantages, including no requirement for vein harvest, use of the access site for concomitant endovascular procedures, and favorable handling characteristics. We compared the short- and mid-term outcomes of BPP and SVP in femoral endarterectomy. Methods: This retrospective, single-center study included 42 patients (49 limbs) who underwent elective femoral endarterectomy with patch closure between September 2016 and January 2025. The patients were grouped by patch type as follows: 28 limbs with BPP and 21 limbs with SVP. Primary endpoints included patency and freedom from target lesion revascularization at the endarterectomy site. Secondary endpoints included perioperative complications, limb salvage, and intraoperative arterial clamp time. Results: No patch-site restenosis or re-intervention occurred in either group. There were no patch infections, and the perioperative complications were similar. Limb salvage at 40 months was 87.5% with BPP vs. 95.0% with SVP (p = 0.42). Intraoperative arterial clamp time was significantly shorter in the BPP group (55.0 vs. 69.5 min, p = 0.01). Conclusions: BPP represents a safe and valuable alternative option for femoral endarterectomy.