1-Year Outcomes of Thromboendarterectomy vs Endovascular Therapy for Common Femoral Artery Lesions

Nakama, Tatsuya; Takahara, Mitsuyoshi; Iwata, Yusuke; Fujimura, Naoki; Yamaoka, Terutoshi; Suzuki, Kenji; Obunai, Kotaro; Tan, Michinao; Shiina, Tsuyoshi; Horie, Kazunori; Sasaki, Shinya; Akamatsu, Daijirou; Takahashi, Hiroki; Yamamoto, Yorimasa; Yasuto, Hoshino; Aihara, H.; Uchiyama, Hidetoshi; Kodama, Takahide; Ohara, Hideaki; Murakami, Kentaro; Kamiya, Yuichi; Sekimoto, Yasuhito; Igari, Kimihiro; Umemoto, Takuya; Jujo, Kentaro; Matsui, Atsushi; Shintani, Yoshiaki; Tabata, Minoru; Kotani, Shinsuke; Hozawa, Koji; Hideto, Yano; Ueshima, Daisuke; Ozaki, Dai; Hayakawa, Naoki; Doijiri, Tatsuki; Tobita, Kazuki; Shimogawara, Tatsuya; Mouri, Shinsuke; Araki, Hiroshi; Yamauchi, Yasutaka; Anzai, Hitoshi; Shintani, Tsunehiro; Hayashi, Masanori; Kato, Tamon; Shinozaki, Norihiko; Banno, Hiroshi; Kojima, Tai; Fujihara, Masahiko; Iida, Osamu; Hata, Yutaka; Kawasaki, Daizo; Nakamura, Jun; Kimura, Masayoshi; Tsubakimoto, Yoshinori; Yamaguchi, Shinichiro; Ichihashi, Shigeo; Tanaka, Hiroyuki; Kobayashi, Taira; Furuyama, Tadashi; Morisaki, Koichi; Sugihara, Makoto; Imoto, Yuki; Doi, Hideki; Suematsu, Nobuhiro; Ito, Hiroyuki; Okadome, Jun; Kyuragi, Ryoichi; Ogata, Kenji; Hayashi, Keita; Fujii, Taku; Isogai, Naoko; Karashima, Eiji

doi:10.1016/j.jcin.2022.03.010

Cited by 18 publications

(15 citation statements)

References 11 publications

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“…Results of endovascular treatment of 946 isolated CFA lesions were reported by Siracuse et al [8] with low rate of periprocedural morbidity and mortality and with dissection rate of 2.9%. Bohme et al have also reported favorable outcome of CFA angioplasty performed in 250 patients, out of which 64 patients had CFA occlusion [11]. The overall complications rate was 9.1% with the primary patency rate of 90.8%, 81.2% and 72% at six, 12, and 24 months, respectively [11].…”

Section: Discussionmentioning

confidence: 97%

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Antegrade dissection of external iliac artery after failed attempt of common femoral artery chronic total occlusion angioplasty

et al. 2022

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Introduction. Endovascular treatment of chronic total occlusion (CTO) represents a true challenge even for experienced interventional radiologists. We are presenting a case of hidden antegrade dissection of external iliac artery (EIA) after failed attempt to recanalize CTO of common femoral artery (CFA). Case outline. Fifty-two-year-old male patient was admitted for multidetector computed tomography angiography. Left common iliac artery (CIA) stenting was performed followed by ?crossover? attempt of recanalization of right CFA CTO that failed. The next day, left femoral superficial artery angioplasty was performed and after one month, angioplasty of the left popliteal and bellow knee arteries. A month later the patient was readmitted for surgical reconstruction of the CFA. After desobstruction, excellent inflow was obtained and Dacron graft inserted. A few hours postoperatively, Fogarty catheter thrombectomy was performed. The next morning pulsations were weakened again and CT angiography showed antegrade dissection of the EIA. Stenting of the EIA was performed with two stents and favourable outcome. After detailed analysis of CT, hidden thrombosed antegrade dissection of EIA was noted in lateral view, that was not seen in posterior/anterior view and was presented as fibrous plaque with mural thrombosis. Dissection occurred after failed attempt of CFA recanalization and was clinically silent until flow was established triggering opening of the false lumen and release of thrombotic masses. Conclusion. In patients with failed angioplasty of chronic total occlusion of CFA and CT characteristics of fibrous plaque proximal of the site of attempted angioplasty, thrombosed antegrade dissection should be thought of.

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Section: Discussionmentioning

confidence: 97%

“…Bohme et al have also reported favorable outcome of CFA angioplasty performed in 250 patients, out of which 64 patients had CFA occlusion [11]. The overall complications rate was 9.1% with the primary patency rate of 90.8%, 81.2% and 72% at six, 12, and 24 months, respectively [11].…”

Section: Discussionmentioning

confidence: 97%

Antegrade dissection of external iliac artery after failed attempt of common femoral artery chronic total occlusion angioplasty

et al. 2022

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“…As mentioned above, type IV lesions were not included in the present study. Calcification was evaluated by computed tomography and angiography as the presence or absence of nodular calcification, which was defined as coral reef-like calcification protruding into the lumen [8]. Angiographic or imaging depiction of CFA lesion types was so far lacking for a study focused on lesion predictors.…”

Section: Patients and Lesionsmentioning

confidence: 99%

“…Although some reports indicate that EVT is equivalent to TEA in terms of patency, others indicate that it is still not as good as TEA [1][2][3][4]. On the other hand, EVT may be superior to TEA in terms of safety, promoting a shift from TEA to EVT [7,8].…”

Section: Introductionmentioning

confidence: 99%

“…To identify lesion characteristics associated with patency after CFA EVT, a large-scale study with periodical assessment of patency is required. Therefore, by analyzing data from the common femoral artery revascularization; investigation of the best strategy from the multicenter retrospective real-world registry (cauliflower) registry database [8], the current study aimed to identify lesion characteristics associated with restenosis risk after EVT for CFA lesions in patients with symptomatic peripheral artery disease (PAD).…”

Section: Introductionmentioning

confidence: 99%

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Lesion Characteristics Associated with Loss of Primary Patency After Endovascular Therapy for Common Femoral Artery Lesions

Yamauchi

Takahara

Iwata

et al. 2023

Cardiovasc Intervent Radiol

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Purpose To identify lesion characteristics associated with restenosis after endovascular therapy (EVT) for common femoral artery (CFA) lesions in patients with peripheral artery disease (PAD) in real-world practice. Materials and Methods We included 751 Japanese patients with PAD who underwent CFA EVT. Data were from a large-scale retrospective multicenter registry study. The association of lesion characteristics with the risk of restenosis was investigated with the Cox proportional hazards regression model. Results Lesions extended to the external iliac artery in 10.0% of patients, were isolated in the CFA in 59.9%, and involved the bifurcation in 30.1%. Chronic total occlusion was noted in 21.1%, and 99% stenosis, in 19.9%. Among the limbs with CFA lesions, 16.4% had a history of CFA EVT. Mean total lesion length was 32 ± 15 mm, and reference vessel diameter, 7.3 ± 1.4 mm. Plain old balloon angioplasty, drug-coated balloon angioplasty, and stent implantation were performed in 56.3, 23.2, and 20.5% of patients, respectively. The mean follow-up period was 10.4 ± 9.5 months. Rates of freedom from restenosis and reintervention at 1 year were 78.2 and 86.6%, respectively. Lesion characteristics independently associated with restenosis were history of CFA EVT, reference vessel diameter less than 6 mm, and lesion length greater than or equal to 50 mm; adjusted hazard ratios were 1.63 (P = 0.007), 1.93 (P = 0.006), and 1.71 (P = 0.018), respectively. Conclusion History of CFA EVT, smaller reference vessel diameter, and longer lesion length are independent risk factors for restenosis after CFA EVT. Level of Evidence Level 3.

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The Endovascular Treatment of the Common Femoral Artery Came to Stay: But Which is the Best Option?

Rabellino

Chiabrando

2023

Cardiovasc Intervent Radiol

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1-Year Outcomes of Thromboendarterectomy vs Endovascular Therapy for Common Femoral Artery Lesions

Cited by 18 publications

References 11 publications

Antegrade dissection of external iliac artery after failed attempt of common femoral artery chronic total occlusion angioplasty

Antegrade dissection of external iliac artery after failed attempt of common femoral artery chronic total occlusion angioplasty

Lesion Characteristics Associated with Loss of Primary Patency After Endovascular Therapy for Common Femoral Artery Lesions

The Endovascular Treatment of the Common Femoral Artery Came to Stay: But Which is the Best Option?

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