Procedures

Femoral thrombendarterectomy and transposition of bifurcation

Learning targets

  • To perform a completely autologous reconstruction of femoral bifurcation
  • To achieve a distal transposition of femoral bifurcation to produce a wide bifurcation
  • To ensure an everting suture technique
  • To improve needle holder-needle interaction (always handle the needle in the operating field)
  • As assistant: to pull sutures in direction of the stitch, and to manage remaining suture length to avoid loops
All Steps in Detail
  1. Arteriotomy of common femoral artery (CFA): use scalpel with blade Nr 11, perform stab incision holding blade upward, extend arteriotomy with Potts scissors
  2. Direction of incision: CFA front wall to the split of the bifurcation, then along inner side of branches (see drawing): alike ‘zipper and sutures’ of a blue jeans
  3. Perform thrombendarterectomy
  4. Fix distal intimal flap using tack down stitches if necessary to avoid dissection
  5. Perform a running suture, starting at back side of reconstruction. Deep femoral artery (DFA) to be sutured from inside out, superficial femoral artery (SFA) to be sutured from outside in. Continue running suture to the middle of CFA
  6. Second suture starting from proximal CFA incision to the middle
  7. Flush and complete anastomosis
  8. Completion angiography

Control of learning targets

Pictures and Drawings

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Links and Downloads

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Courses Teaching this Procedure

Basic Vascular Surgery Techniques 2026

Jan 18, 2026
 - 
Jan 20, 2026
More Information

Simulators Used for this Procedure

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About Vascular International

The Vascular International (VI) School for Vascular Surgery is dedicated to advancing the training and education of vascular surgical techniques through the use of lifelike models. With patient safety as the top priority, VI continuously strives to enhance vascular surgery training, ensuring the highest standards of safe and effective open and endovascular patient care.

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