Skip to Content

Remote Superficial Femoral Artery Endarterectomy


Remote superficial femoral artery endarterectomy (RSFAE) is a procedure to remove plaque inside the superficial femoral artery. The femoral artery is the main blood vessel in your thigh that carries blood and oxygen to the legs. Plaque is made up of fat, cholesterol, or tissues that are in the inner wall of the artery and may clog the artery. RSFAE helps improve blood flow and relieve symptoms caused by a narrowed or blocked artery.


Before your procedure:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  • Blood tests: You may need blood taken to give healthcare providers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.
  • Medicines:
    • Antiplatelets help prevent blood clots. This medicine makes it more likely for you to bleed or bruise.
    • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
  • Pre-op care: You may be given medicine right before your procedure or surgery. This medicine may make you feel relaxed and sleepy. You are taken on a stretcher to the room where your procedure or surgery will be done, and then you are moved to a table or bed.
  • Anesthesia: This medicine is given to make you comfortable. You may not feel discomfort, pressure, or pain. An adult will need to drive you home and should stay with you for 24 hours. Ask your healthcare provider if you can drive or use machinery within 24 hours. Also ask if and when you can drink alcohol or use over-the-counter medicine. You may not want to make important decisions until 24 hours have passed.
  • Monitoring:
    • Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.
    • A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine.

During your procedure:

  • You may be given medicine to help you relax or make you drowsy. You will be taken to the room where the procedure will be done. X-rays with a monitor will be used to guide healthcare providers during the procedure. Healthcare providers will clean your skin and sheets will be put over you to keep the area clean. You will get anesthesia medicine to numb the area where the procedure will be done.
  • Healthcare providers will make a small incision in your groin to see the femoral artery. Dye may be put in the artery to make the blocked area show up better. Healthcare providers will then make a small incision in the artery and use small tools to separate the plaque from the blood vessel wall. When the end of the artery blockage is reached, the plaque is cut and removed from the artery. Dye is again put into the artery and pictures are taken to make sure the plaque was completely removed. Angioplasty may then be done and a stent placed inside the artery. The incisions will be closed with stitches or staples and covered with tight pressure bandages.

After your procedure:

  • You will be taken to a room where you can rest. Healthcare providers will watch you closely for any problems. Later, you will be taken to your hospital room, or you may be able to go home. A bandage may cover your stitches or staples. This bandage keeps the area clean and dry to help prevent infection.
  • You will need to lie flat and still in bed for a few hours. Keep your leg straight and do not move it until your healthcare provider tells you it is okay. The pulses of your legs and in your feet will be checked often. This may show healthcare providers if you have any problems with blood flow after your procedure. You may need to place your fingers over the incision area if you need to cough or sneeze. Your healthcare provider will tell you when it is okay to get out of bed. Call your healthcare provider before you get up for the first time. If you feel weak or dizzy after you get up, sit or lie down right away and call a healthcare provider.
  • Medicines:
    • Antinausea medicine: This medicine may be given to calm your stomach and to help prevent vomiting.
    • Pain medicine: You may be given a prescription medicine to decrease pain. Do not wait until the pain is severe before you ask for more medicine.
  • You may need to wear inflatable boots after surgery. The boots have an air pump that tightens and loosens different areas of the boots. This device improves blood flow and helps prevent clots.
  • A Foley catheter is a tube put into your bladder to drain urine into a bag. Keep the bag below your waist. This will prevent urine from flowing back into your bladder and causing an infection or other problems. Also, keep the tube free of kinks so the urine will drain properly. Do not pull on the catheter. This can cause pain and bleeding, and may cause the catheter to come out.


  • RSFAE may lead to an infection, trouble breathing, or a blood clot. The clot may travel to your heart or brain and cause life-threatening problems, such as a heart attack or stroke. Even after the procedure, the artery may become narrow again. The blood vessel used for the procedure may tear, and cause bleeding.
  • Without RSFAE, your symptoms, such as leg pain, trouble walking, and tiring easily, may worsen. If parts of your leg do not get enough blood and oxygen, you may need part of your leg amputated (removed). Your condition may also lead to a heart attack or stroke.


You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment.

© Copyright IBM Corporation 2018 Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or IBM Watson Health

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.