Angioplasty and Provisional Stent Treatment of Common Femoral Artery Lesions

Bonvini, Robert F.; Rastan, Aljoscha; Sixt, Sebastian; Beschorner, Ulrich; Noory, Elias; Schwarz, Thomas; Roffi, Marco; Dorsaz, Pierre-André; Schwarzwälder, Uwe; Bürgelin, Karlheinz; Macharzina, Roland; Zeller, Thomas

doi:10.1016/j.jvir.2012.10.020

Cited by 40 publications

(71 citation statements)

References 27 publications

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“…Endovascular stents at the CFA are also susceptible to fracture and kinking due to frequent flexion and movement at the inguinal ligament 25,26. Stenting in the CFA has been associated with high risk of intervention in a recent study, although there remains a lack of consensus with conflicting published data 24,27,28. The American College of Surgeons’ National Surgical Quality Improvement Project database demonstrated that CFE is well tolerated by patients with PAD, showing a 30-day mortality rate of 1.5% and at least one complication in 7.9% of patients.…”

Section: Common Femoral Endarterectomy (Cfe)mentioning

confidence: 99%

Infrainguinal open reconstruction: a review of surgical considerations and expected outcomes

Komshian

Pike

et al. 2017

VHRM

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Infrainguinal arterial occlusive disease can lead to potentially disabling and limb-threatening conditions. Revascularization may be indicated for claudication, rest pain, or tissue loss. Although endovascular interventions are becoming more prevalent, open surgeries such as endarterectomy and bypass are still needed and performed regularly. Open reconstruction has been associated with postoperative morbidity, both at the local and at the systemic levels. Local complications include surgical site infections (SSIs 0–5.3%), graft failure (12–60%), and amputation (5.7–27%), and more systemic issues include cardiac (2.6–18.4%), respiratory (2.5%), renal (4%), neurovascular (1.5%), and thromboembolic (0.2–1%) complications. While such outcomes present an additional challenge to the postoperative management of surgical patients, it may be possible to minimize their occurrence through careful risk stratification and preoperative assessment. Therefore, individualized selection of candidates for open repair requires weighing the need for intervention against the likelihood of adverse outcomes based on preoperative risk factors. This review provides an overview of open reconstruction, focusing on identifying the clinical indications for surgery and perioperative morbidity and mortality.

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Section: Common Femoral Endarterectomy (Cfe)mentioning

confidence: 99%

Infrainguinal open reconstruction: a review of surgical considerations and expected outcomes

Komshian

Pike

et al. 2017

VHRM

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“…This hypothesis is further supported by growing scientific evidence on endovascular strategies within the iliofemoral axis, showing low rates of stent fracture and instent-restenosis in primary endovascular treatment for isolated CFA. 21,22 Despite the fact that clinical evidence on stent graft placement in the context of TAVI-associated iliofemoral complications is limited, the available results are promising. De Backer et al 11 detected virtually no instent-restenosis and no signs of stent fractures in a cohort of 48 patients treated with the Viabahn stent graft for TAVI-related access-site injury over a median follow-up period of ≈1 year.…”

Section: Stent Graft Placement For Asarvimentioning

confidence: 99%

Routine Endovascular Treatment With a Stent Graft for Access-Site and Access-Related Vascular Injury in Transfemoral Transcatheter Aortic Valve Implantation

Sedaghat

Neumann

Schahab

et al. 2016

Circ: Cardiovascular Interventions

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Background-Access-site and access-related vascular injury (ASARVI) is still a major limiting factor in transcatheter aortic valve implantation and affects the outcome of patients. Management strategies for ASARVI include manual compression, stent grafts, and vascular surgery. We hypothesized that the standard use of a self-expanding stent graft for the management of ASARVI is feasible and safe. Methods and Results-Of 407 patients treated by transfemoral transcatheter aortic valve implantation, 110 experienced ASARVI (27.0%). Of these, 96 (87.3%) were managed by the implantation of a self-expanding nitinol stent graft. In the majority of patients, minor vascular complications triggered the implantation of a stent graft (86.5%), mainly because of bleeding (90.6%) and dissection (5.2%) of the common femoral artery with high rates of primary treatment success (97.9%

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“…Recent studies involving solely endovascular treatment for CFA lesions are conflicting [8]- [11]. Bonvini et al analyzed 360 consecutive percutaneous interventions of the CFA for atherosclerotic disease [8].…”

Section: Discussionmentioning

confidence: 99%

“…Bonvini et al analyzed 360 consecutive percutaneous interventions of the CFA for atherosclerotic disease [8]. Balloon angioplasty was performed as the primary intervention in virtually all cases, while 36.9% of procedures required a stent for suboptimal angioplasty [9].…”

Section: Discussionmentioning

confidence: 99%

“…However, unlike superficial femoral artery atherosclerotic disease, lesions in the common femoral artery (CFA) require special consideration with regard to endovascular treatment. Studies utilizing endovascular therapy for CFA occlusive disease have demonstrated variable results [8]- [11]. The anatomical location of CFA atherosclerotic disease precludes sole endovascular therapy.…”

Section: Introductionmentioning

confidence: 99%

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Hybrid Procedure Utilizing Stent Grafts to Stabilize Distal Flaps after Common and Superficial Femoral Endarterectomy

Pham¹,

Protyniak²,

Hui³

et al. 2015

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Background: Endarterectomy has long been the standard for common femoral artery (CFA) occlusive disease. Hybrid procedures utilizing endovascular and open techniques have recently been used for revascularization. The purpose of this study was to evaluate the effectiveness of the use of a stent graft to stabilize the distal flap and prevent further dissection after extensive endarterectomy. Methods: All patients from Monmouth Medical Center in Long Branch, NJ from September 2008 to March 2013 who underwent an extensive common and superficial femoral (SFA) endarterectomy combined with the use of a Viabahn (Gore Medical) stent graft to stabilize the distal flap were included in the study. These stents were deployed in the proximal SFA after extensive endarterectomy, under direct visualization, without the aid of fluoroscopy. Due to the location in the SFA, these flaps were not amenable to suture tacking. Results: Fifteen patients met these criteria and were included in our study. Twelve patients underwent femoral endarterectomy for severe claudication and three patients for limb salvage. Technical success was achieved in all 15 patients. Five patients also had stents placed proximally to increase inflow and one patient had an additional stent placed distally to improve outflow. There were no intraoperative or postoperative complications. Conclusion: Stent graft placement allows a more extensive endarterectomy to be performed by stabilizing the distal flap allowing a safe transition into the true lumen that is not possible with suture tacking.

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Angioplasty and Provisional Stent Treatment of Common Femoral Artery Lesions

Cited by 40 publications

References 27 publications

Infrainguinal open reconstruction: a review of surgical considerations and expected outcomes

Infrainguinal open reconstruction: a review of surgical considerations and expected outcomes

Routine Endovascular Treatment With a Stent Graft for Access-Site and Access-Related Vascular Injury in Transfemoral Transcatheter Aortic Valve Implantation

Hybrid Procedure Utilizing Stent Grafts to Stabilize Distal Flaps after Common and Superficial Femoral Endarterectomy

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