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Peer-Review Record

Determinants of Success and Early Complications in Common Femoral Artery Endarterectomy: A Retrospective Study

Reviewer 1: Anonymous
Reviewer 2: Anonymous
Reviewer 3: Anton Kutikhin
Received: 6 April 2021 / Revised: 8 May 2021 / Accepted: 25 May 2021 / Published: 29 May 2021

Round 1

Reviewer 1 Report

Thank you very much and good luck for your paper

Author Response

Thank you for the positive feedback and revision advices.

Reviewer 2 Report

Dear Authors,

interesting and quite nice written manuscript. 

Even though the idea is new, this manuscript needs major revision. To my surprise the variable emergency operation has the most impact on the outcome even in multiple model. Emergency was in 17% of 227 patients, around 38 patients. A sub-group analysis on these patients concerning comorbities would enhance the manuscript. These patients are probably very ill concerning ASA, emergency operation etc.

Furthermore the comorbidities have significant more influence on outcome than any additional endovascular treatment. This might be due to the low number of patients and the inhomogeinity of patients. Comparing femoral patch with femoral patch and additional iliac PTA/stent would really identify the schientific question whether endovascular treatment has additional advantage or disadvantage.

Author Response

interesting and quite nice written manuscript.

Authors : Thank you for the positive feedback and revision advices.

1 : Even though the idea is new, this manuscript needs major revision. To my surprise the variable emergency operation has the most impact on the outcome even in multiple model. Emergency was in 17% of 227 patients, around 38 patients. A sub-group analysis on these patients concerning comorbities would enhance the manuscript. These patients are probably very ill concerning ASA, emergency operation etc. Furthermore the comorbidities have significant more influence on outcome than any additional endovascular treatment. This might be due to the low number of patients and the inhomogeinity of patients.

Authors :

Thank you for this useful comment. Concerning the emergency operation group, we performed subgroup analysis of the groups undergoing emergency operation. It showed, as you predicted, significant more comorbidities and thus, predicting worse outcome. It is described in the results- (lines 206-211) and discussion section (lines 260-262) of the revised manuscript.

1: Comparing femoral patch with femoral patch and additional iliac PTA/stent would really identify the scientific question whether endovascular treatment has additional advantage or disadvantage.

Authors :

Thank you for your feedback on the comparison between additional iliac PTA/stent. This is analyzed and described in the results section. See table 5 and line 205-213 in the original manuscript.

Reviewer 3 Report

Here Quax and co-authors reported the results of the retrospective analysis of complications upon common femoral artery endarterectomy in the Netherlands. Authors found that emergency surgical procedure and co- or multimorbidity (i.e., higher ASA class and renal failure) as well as higher extent of ischemia (Rutherford class) are associated with higher risk of complications (including thrombosis and unplanned amputation) and death upon the procedure.

Albeit this is a single-center and retrospective study, it is well performed and the data are properly analysed; therefore, it deserves publication in Surgeries.

Author Response

Thank you for the positive feedback

Round 2

Reviewer 2 Report

nice improvement.

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