A pooled analysis of common femoral and profunda femoris endovascular interventions

Bath, Jonathan; Avgerinos, Efthimios D.

doi:10.1177/1708538115604929

Cited by 29 publications

(17 citation statements)

References 55 publications

(78 reference statements)

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“…More than 50 per cent of patients with PAD undergoing CFE require concomitant endovascular intervention (hybrid procedures) to diseased ipsilateral arteries. Two reviews previously concluded that endovascular interventions to CFA can be performed safely with a high rate of technical success. Since then, two RCTs and two case series on endovascular CFA treatment have been published.…”

Section: Introductionmentioning

confidence: 99%

Systematic review of endovascular intervention and surgery for common femoral artery atherosclerotic disease

Jia

Sun

Patel

et al. 2019

Journal of British Surgery

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Background Endovascular intervention has emerged as a potential alternative to open surgery in treating common femoral artery (CFA) atherosclerotic disease. The aim of this systematic review was to assess the safety and efficacy of both techniques. Methods Thirteen electronic databases from 1980 to 3 January 2018 were searched. Study quality was assessed using the National Institute for Health and Care Excellence Interventional Procedure Programme quality assessment tool. Safety and efficacy outcome measures were analysed. Results Thirty‐one studies reporting 813 endovascular procedures and 3835 endarterectomies were included. Only two small RCTs have been reported. The methodological quality of available studies was generally low and follow‐up short. Safety endpoint assessment revealed a similar risk of wound haematoma for endovascular intervention and endarterectomy (5·5 (95 per cent c.i. 0·2 to 17·2) versus 3·9 (1·7 to 6·9) per cent respectively), a lower risk of wound infection with endovascular procedures (0 versus 5·9 (3·4 to 9·0) per cent) and a lower risk of wound lymph leakage (0 versus 5·7 (3·3 to 8·6) per cent). Efficacy endpoint assessment at 1 year identified that endovascular intervention had a lower primary patency rate than endarterectomy (78·8 (73·3 to 83·8) versus 96·0 (92·2 to 98·6) per cent respectively), a higher revascularization rate (16·0 (6·1 to 29·4) versus 5·8 (1·0 to 14·2) per cent) and a similar amputation rate (2·7 (1·2 to 4·8) versus 1·9 (0·7 to 3·8) per cent). Conclusion Endovascular intervention of CFA disease appears to reduce the risk of wound complications but is associated with a lower patency rate and increased rates of subsequent revascularization procedures. Standardization of the endovascular technique and quantification of the proportions of patients suitable for either technique are required.

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Section: Introductionmentioning

confidence: 99%

Systematic review of endovascular intervention and surgery for common femoral artery atherosclerotic disease

Jia

Sun

Patel

et al. 2019

Journal of British Surgery

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“…In a retrospective study with CFA lesions treated exclusively by balloon angioplasty, a relatively high re-intervention rate of 43% was found after 3 years in a group of patients with an elevated percentage of CLI [13]. A pooled analysis of common femoral vascular interventions showed a significantly higher mean primary patency at 12 months for routine stenting compared to a selective stenting strategy (91.4% vs. 75%) [11]. This study distinguishes itself from previous ones by the high number of included interventions, the strict adherence to an intervention protocol where every lesion was set to be stented exclusively by self-expanding stents, and ultimately the long follow-up period.…”

Section: Discussionmentioning

confidence: 97%

“…Endovascular treatment of CFA lesions is appealing due to its less invasive nature as compared with CFE, the possibility of outpatient treatment, and the avoidance of infection and lymphatic complications. Over the last years, there have been a growing number of endovascular treatment studies published, which were mostly retrospective, frequently including a relatively small number of patients, reporting limited follow-up time, and using different techniques, in particular with respect to stenting [7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Stent-Assisted Angioplasty (SAA) at the Level of the Common Femoral Artery Bifurcation: Long-Term Outcomes

Stricker

Spinedi

Limoni

et al. 2020

Cardiovasc Intervent Radiol

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Background The objective of this retrospective singlecenter study was to report the initial and the long-term outcome after stent-assisted angioplasty of occlusive disease at the common femoral artery. Materials and Methods Between 1995 and 2015, 94 limbs in 79 consecutive patients (54 men; mean age 70 ± 8.6 years) underwent angioplasty with self-expanding stent implantation in 94 common femoral arteries. Critical limb ischemia was present in 15 limbs (16%); the other patients had claudication. Results Technical success was 99%. Complications occurred in 5/94 interventions (5.3%): puncture site hematomas (2), arteriovenous fistula (1), cholesterol embolism (1), and dissection of the access site artery (1). The intervention was outpatient-based in 98%. Median follow-up was 53 months. Ankle-brachial index (ABI) rose from 0.71 ± 0.17 to 1.0 ± 0.2 (p \ .001) immediately after the intervention and was 1.03 ± 0.2 after 1 year and 0.96 ± 0.21 at the last follow-up visit (p \ .001 compared to pre-interventional ABI). During follow-up, restenosis was found in 23/94 limbs (25%); 15 limbs were treated by angioplasty, 3 by surgery, and 5 conservatively. One limb was amputated below the knee 6 months after stent-assisted angioplasty (SAA). Death rate during followup was 35/79 patients (44%). Conclusions SAA of the CFA resulted in high immediate success and a low complication rate. Restenosis rate was moderate, and target lesions could easily be retreated by angioplasty. The main hazard was not restenosis, but death during follow-up.

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“…In addition, there is an ongoing debate regarding the treatment of the common femoral artery fueled by the advances in endovascular therapy. Advertised benefits are lower mortality and morbidity and a high technical success in endovascular treatment (11,12).…”

Section: Introductionmentioning

confidence: 99%

Long-Term Outcome of Common Femoral Artery Endarterectomy In Octogenarians and Non-Octogenarians

et al. 2020

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Objective: Arteriosclerotic disease of the common femoral artery can be treated by surgical or endovascular intervention. Elderly patients are said to have a worse outcome if treated by surgical means; however, data to support this theory are missing. Methods: Retrospective analysis of all patients who underwent common femoral artery endarterectomy between March 2007 and July 2018 in our clinic. Group 1 included all patients <80 years and Group 2 included all patients ⩾80 years. Endpoints were patency rates, limb salvage, and overall survival. Results: During this time period, 977 common femoral artery endarterectomies were performed. Indication was claudication in 61.5% and critical limb ischemia in 38.5%. Group 1 included 805 cases (82.4%) and Group 2 included 172 cases (17.6%). Thirty-day mortality was 2.7% (Group 1 = 1.6% versus Group 2 = 7.6%; p < 0.001) and 30-day major amputation was 1.1% (Group 1 = 0.7% versus Group 2 = 2.9%; p = .043). Primary patency and secondary patency were 84.2% and 96.8%, respectively, after 7 years. Limb salvage (93.7%, Group 1 = 94.1% versus Group 2 = 91.8%; p = .088) and overall survival (52.0%, Group 1 = 59.1% versus Group 2 = 15.7%; p = .006) were significantly different after the same time period. Multivariable analysis showed female gender to be a risk factor for loss of primary patency. Age ⩾ 80 years and ulcer or gangrene were risk factors for death. Statin use was beneficial to survival. Conclusion: Common femoral artery endarterectomy is a safe procedure with excellent long-term results. Octogenarians have an increased risk for perioperative mortality and major amputation.

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A pooled analysis of common femoral and profunda femoris endovascular interventions

Cited by 29 publications

References 55 publications

Systematic review of endovascular intervention and surgery for common femoral artery atherosclerotic disease

Systematic review of endovascular intervention and surgery for common femoral artery atherosclerotic disease

Stent-Assisted Angioplasty (SAA) at the Level of the Common Femoral Artery Bifurcation: Long-Term Outcomes

Long-Term Outcome of Common Femoral Artery Endarterectomy In Octogenarians and Non-Octogenarians

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