Endovascular Treatment of Common Femoral Artery Disease

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

doi:10.1016/j.jacc.2011.01.070

Cited by 141 publications

(32 citation statements)

References 13 publications

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“…However, even in these locations, single-center series suggest treatment comprised of percutaneous angioplasty with provisional stenting is associated with acceptable 12-month results particularly in high-risk surgical patients requiring limb salvage. 16 Endovascular approaches without stenting in these regions include atherectomy and balloon angioplasty alone. The development of drug-coated balloons (DCBs) with adjunctive atherectomy may address some issues associated with stent placement in these challenging arterial segments although any flow-limiting dissections, recalcitrant recoil, or residual disease would still limit such an approach.…”

Section: Strategies For Pvimentioning

confidence: 99%

Endovascular Intervention for Peripheral Artery Disease

2015

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Advances in endovascular therapies during the past decade have broadened the options for treating peripheral vascular disease percutaneously. Endovascular treatment offers a lower risk alternative to open surgery in many patients with multiple comorbidities. Noninvasive physiological tests and arterial imaging precede an endovascular intervention and help localize the disease and plan the procedure. The timing and need for revascularization are broadly related to the 3 main clinical presentations of claudication, critical limb ischemia, and acute limb ischemia. Many patients with claudication can be treated by exercise and medical therapy. Endovascular procedures are considered when these fail to improve quality of life and function. In contrast, critical limb ischemia and acute limb ischemia threaten the limb and require more urgent revascularization. In general, endovascular treatments have greater long-term durability for aortoiliac disease than femoral popliteal disease. Infrapopliteal revascularization is generally reserved for critical and acute limb ischemia. Balloon angioplasty and stenting are the mainstays of endovascular therapy. New well-tested innovations include drug-eluting stents and drug-coated balloons. Adjunctive devices for crossing chronic total occlusions or debulking plaque with atherectomy are less rigorously studied and have niche roles. Patients receiving endovascular procedures need a structured surveillance plan for follow-up care. This includes intensive treatment of cardiovascular risk factors to prevent myocardial infarction and stroke, which are the main causes of death. Limb surveillance aims to identify restenosis and new disease beyond the intervened segments, both of which may jeopardize patency and lead to recurrent symptoms, functional impairment, or a threatened limb.

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Section: Strategies For Pvimentioning

confidence: 99%

Endovascular Intervention for Peripheral Artery Disease

2015

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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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“…Some promising techniques for instance common femoral artery angioplasty with optional bifurcation treatment requires validation and appear to be interesting option and alternative to surgery way of treatment [25].…”

Section: Discussionmentioning

confidence: 99%