The Role of Common Femoral Artery Endarterectomy in the Endovascular Era

Nishibe, Toshiya; Maruno, Keita; Iwahori, Akinari; Fujiyoshi, Toshiki; Suzuki, Shun; Takahashi, Satoshi; Ogino, Hitoshi; Nishibe, Masayasu

doi:10.1016/j.avsg.2015.05.005

Cited by 29 publications

(22 citation statements)

References 16 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 number of studies reported the durability of open repair with primary patency rates up to 96% at 7 years. [1][2][3][4] On the other hand, although surgical repair is considered by many physicians a safe and technically straightforward procedure, it is associated with a significant rate of local complications and perioperative morbidity. 5,6 Nguyen et al 6 reported a 15% combined rate of overall mortality and major complications; 10% of patients were returned to the operating room.…”

Section: Discussionmentioning

confidence: 99%

“…Common femoral artery (CFA) disease, however, is a notable exception because surgical endarterectomy is still considered the gold standard. Although several publications demonstrated the durability of open repair, [1][2][3][4][5][6] the relatively high rate of perioperative morbidity remains a drawback of surgical revascularization.…”

Section: Introductionmentioning

confidence: 99%

Directional Atherectomy With Antirestenotic Therapy vs Drug-Coated Balloon Angioplasty Alone for Common Femoral Artery Atherosclerotic Disease

et al. 2017

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“…Whereas this patient's relatively good health and young age reinforced the indication for an open bypass procedure, a traditional approach was not optimal in the absence of venous conduit and adequate tissue cover at the PT artery. Instead, inflow was optimized with an endarterectomy as femoral endarterectomy has high technical success and durability with little morbidity 9 . Outflow was then optimized with angioplasty.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of “unreconstructable” critical limb ischemia with hybrid techniques

Power

Chung

Lajos

et al. 2016

Journal of Vascular Surgery Cases

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This case describes the surgical repair of critical limb ischemia in a patient with diffuse multilevel peripheral arterial disease. It demonstrates the value of patient-specific approaches that employ hybrid endovascular and open surgical techniques to reconstruct blood flow in patients who are not ideal candidates for traditional revascularization. We detail a technique that combines endarterectomy, femoropopliteal bypass, angioplasty, and stenting. This case suggests that innovative hybrid approaches can be used to achieve limb salvage in some patients with multilevel peripheral vascular disease who would otherwise undergo primary amputation.

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The Role of Common Femoral Artery Endarterectomy in the Endovascular Era

Cited by 29 publications

References 16 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

Directional Atherectomy With Antirestenotic Therapy vs Drug-Coated Balloon Angioplasty Alone for Common Femoral Artery Atherosclerotic Disease

Reconstruction of “unreconstructable” critical limb ischemia with hybrid techniques

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