Endovascular Treatment of Common Femoral Artery Disease: Medium-Term Outcomes of 360 Consecutive Procedures

Study Questions:

What is the outcome of patients undergoing endovascular treatment for common femoral artery (CFA) disease?

Methods:

The authors reported the in-hospital and 1-year outcomes of 360 consecutive percutaneous interventions of the CFA at a single center.

Results:

Most CFA interventions were performed in patients who were undergoing additional intervention to inflow (157, 44%) or outflow vessels (152, 42%), whereas the rest involved isolated CFA interventions (97, 26.9%). Bifurcation lesions were present in 140 cases (38.9%), and concomitant treatment of the profunda femoral artery was performed in 26%. Recannalization of a total CFA occlusion was performed in 60 cases (16.7%). Balloon angioplasty was performed as the primary intervention in 99% of the cases, and stenting for suboptimal angioplasty result was performed in 133 procedures (36.9%). Procedural complications occurred in 23 procedures (6.4%), of which five (1.4%) required surgery and the remaining 18 (5.0%) were treated percutaneously or conservatively. One-year follow-up data were available for 281 patients (87.5%). Restenosis >50% by duplex scanning occurred in 27.6% of patients, and target lesion revascularization was performed in 64 of 322 (19.9%) procedures.

Conclusions:

The authors concluded that endovascular treatment of CFA lesions is safe and efficacious, and may be a reasonable alternative to surgery.

Perspective:

Surgery has been traditionally preferred for CFA lesions, although an increasing number of patients are being treated with an endovascular approach. This study demonstrates that this is a safe strategy, with a reasonable 1-year outcome. The CFA is a highly mobile artery, and there are no stents that are uniquely designed for this bed. The lack of long-term data on stent fractures and the need to preserve access for coronary and other vascular procedures suggests that stents should be avoided in this bed as far as possible. Nonetheless, patients in this study were predominantly treated with angioplasty and bailout stenting, and the favorable results observed suggest that this may be a reasonable approach in selected patients.

Clinical Topics: Invasive Cardiovascular Angiography and Intervention

Keywords: Cardiology, Femoral Artery, Iliac Artery, Angioplasty, Balloon, Coronary, Stents


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