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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.


The week before your procedure:

  • Ask your healthcare provider if you need to stop using any of your medicines. If you take aspirin, ibuprofen, or blood thinners, do not stop taking them without first asking your healthcare provider.
  • Bring your medicine bottles or a list of your medicines when you see your healthcare provider. Tell your provider if you are allergic to any medicine. Tell your provider if you use any herbs, food supplements, or over-the-counter medicine.
  • You will be given a dye during your procedure to help healthcare providers see your blood vessels better. Tell the healthcare provider if you have ever had an allergic reaction to contrast dye.
  • Tell your healthcare provider if you know or think you might be pregnant.
  • You may need to have blood tests, an EKG, chest x-ray, and other tests. Ask your healthcare provider for more information about these and other tests that you may need. Write down the date, time, and location of each test.
  • Write down the correct date, time, and location of your procedure.

The night before your procedure:

Ask healthcare providers about directions for eating and drinking.

The day of your procedure:

  • Ask your healthcare provider before taking any medicine on the day of your procedure. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring a list of all the medicines you take, or your pill bottles, with you to the hospital.
  • If you wear contact lenses, do not wear them on the day of your procedure or surgery. Glasses may be worn.
  • Healthcare providers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
  • An anesthesiologist will talk to you before your surgery. You may need medicine to keep you asleep or numb an area of your body during surgery. Tell healthcare providers if you or anyone in your family has had a problem with anesthesia in the past.
  • You or a close family member will be asked to sign a legal document called a consent form. It gives healthcare providers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.


What will happen:

  • 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 may be transferred to a room after your procedure. You will need to lie flat in bed for a time. Keep your leg straight and do not move the leg where the RSFAE was done. Do not get out of bed until your healthcare provider says it is okay. Healthcare providers will watch you closely for any problems. When healthcare providers see that you are okay, you may be taken to your hospital room. The bandages used to cover your stitches or staples will keep the area clean and dry to prevent infection. Healthcare providers may remove the bandage soon after the procedure to check the incision.


  • You cannot make it to your procedure appointment on time.
  • You have a fever.
  • You have a wound near the area where the procedure will be done.
  • You have questions or concerns about your procedure.

Seek Care Immediately if

  • You have pain or discomfort in your back, neck, jaw, stomach, or arm.
  • You have discomfort in your chest that feels like squeezing, pressure, fullness, or pain.
  • You suddenly feel lightheaded or have trouble breathing.
  • You have weakness in an arm or leg.
  • You become confused, or have difficulty speaking.
  • You have dizziness, a severe headache, or vision loss.


  • 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.

Care Agreement

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.

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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.