Long-Term Outcomes of Common Femoral Artery Stenting

Nasr, Bahaa; Kaladji, Adrien; Vent, Pierre-Alexandre; Chaillou, Philippe; Costargent, Alain; Quillard, Thibaut; Gouëffic, Yann

doi:10.1016/j.avsg.2016.07.088

Cited by 35 publications

(24 citation statements)

References 26 publications

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“…CFA lesions have been classified into four types: type I lesions extend proximally from the CFA into the external iliac artery; type II lesions are limited to the CFA; type III lesions are the most complex, and involve the CFA and its bifurcation; and type IV lesions represent stenosis of a bypass anastomosis. This systematic review excluded type IV lesions. The reported endovascular techniques for treating type I and II lesions were relatively consistent, comprising standard balloon angioplasty with or without stent placement.…”

Section: Discussionmentioning

confidence: 99%

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

Jia

Sun

Patel

et al. 2018

British Journal of 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: Discussionmentioning

confidence: 99%

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

Jia

Sun

Patel

et al. 2018

British Journal of Surgery

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“…A similar retrospective study published recently included 36 patients for a mean follow-up of 64 months, with a primary patency rate after 3 and 5 years of 76 and 72%, respectively, a perioperative complication rate of 5%, and a cumulative mortality of 50%, which is in line with our results. Whereas our patients were mostly treated on an outpatient basis, those patients were hospitalized between 1 and 15 days [14].…”

Section: Discussionmentioning

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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Section: Endovascular Therapies Of the Cfamentioning

confidence: 99%

“…Azema et al 7 and Nasr et al 8 published a prospective study on 36 patients (40 limbs) treated with stenting in the CFA. An early report was published by Azema et al 7 with a follow-up at a mean of 22 months followed by Nasr et al 8 at a mean follow-up of 64 months. CFA lesions were classified into type I: 20%disease to the CFA extended to external iliac lesions; type II: 42.5%isolated lesions of the CFA; type III: 25%lesions of the femoral bifurcation; type IV: 12.5%proximal or distal anastomotic lesions bypass surgery.…”

Section: Endovascular Therapies Of the Cfamentioning

confidence: 99%

<p>An Overview of the Treatment of Symptomatic Common Femoral Artery Lesions with a Focus on Endovascular Therapy</p>

Shammas¹,

Doumet²,

Karia³

et al. 2020

VHRM

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Endarterectomy of common femoral artery lesions (CFA) carries favorable longterm results and is currently still considered the gold standard for treating these lesions. Although routine stenting has been considered an option for treating the CFA, it has yielded conflicting results and is currently reserved for a bailout of suboptimal endovascular results. Newer therapies with atherectomy or lithoplasty in conjunction with pharmacologic antiproliferative therapies are promising with less bailout stenting and dissections but randomized trials are needed to confirm their effectiveness and safety.

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Long-Term Outcomes of Common Femoral Artery Stenting

Cited by 35 publications

References 26 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

<p>An Overview of the Treatment of Symptomatic Common Femoral Artery Lesions with a Focus on Endovascular Therapy</p>

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