Endovascular Treatment of the Common Femoral Artery for Limb Ischemia

Abstract

Objective:

To determine the short- and mid-term outcomes of percutaneous endovascular common femoral artery (CFA) revascularization (eCFR) of the CFA.

Methods:

A review of patients who underwent eCFR for limb ischemia between 2006 and 2012 was performed. Limb salvage, patient survival, survival free from reintervention, and survival free from amputation rates were determined. Median (range) follow-up was 28 (1-71) months.

Results:

In all, 115 patients underwent 121 eCFR for CFA occlusion (n = 13) or stenosis (n = 108); 109 (90%) were technically successful and 7 (6%) had significant perioperative complications; access site hematoma (n = 2) and thromboembolism (n = 5). Thirty-day mortality and amputation rates were 2.5% and 0.8%, respectively. The 1- and 3-year limb salvage rates were 97% and 97%, respectively. The 1- and 3-year survival free from reintervention rates were 77% and 57%, respectively. The 1- and 3-year survival free from amputation rates were 84% and 70%, respectively.

Conclusion:

These novel data demonstrate that eCFR is a durable treatment for patients with limb ischemia associated with CFA disease.

Keywords

peripheral angioplasty common femoral artery peripheral arterial disease

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References

Norgren

Hiatt

Dormandy

Nehler

Harris

Fowkes

. Inter-society consensus for the management of peripheral arterial disease (TASC II). J Vasc Surg. 2007;45(suppl S):S5–S67.

Dos Santos

. Sur la désobstruction des thromboses artérielle anciennes. Mem Acad Chir (Paris). 1947;73(18-19):409–411.

Ballotta

Gruppo

Mazzalai

DaGiau

. Common femoral artery endarterectomy for occlusive disease: an 8-year single-center prospective study. Surgery. 2010;147(2):268–274.

Kang

Patel

Conrad

Lamuraglia

Chung

Cambria

. Common femoral artery occlusive disease: contemporary results following surgical endarterectomy. J Vasc Surg. 2008;48(4):872–877.

Chang

Goodney

Baek

Nolan

Rzucidlo

Powell

. Long-term results of combined common femoral endarterectomy and iliac stenting/stent grafting for occlusive disease. J Vasc Surg. 2008;48(2):362–367.

Cotroneo

Iezzi

Marano

Fonio

Nessi

Gandini

. Hybrid therapy in patients with complex peripheral multifocal steno- obstructive vascular disease: two-year results. Cardiovasc Interv Radiol. 2007;30(3):355–361.

Schrijver

Moll

DeVries

. Hybrid procedures for peripheral obstructive disease. J Cardiovasc Surg (Torino). 2010;51(6):833–843.

Bonvini

Rastan

Sixt

. Endovascular treatment of common femoral artery disease: medium-term outcomes of 360 consecutive procedures. J Am Coll Cardiol. 2011;58(8):792–798.

Norgren

Hiatt

Dormandy

. Inter-society consensus for the management of peripheral arterial disease (TASC II). J Vasc Surg. 2007;(45 suppl S):S5–S67.

10.

Azéma

Davaine

Guyomarch

. Endovascular repair of common femoral artery and concomitant arterial lesions. Eur J Vasc Endovasc Surg. 2011;41(6):787–793.

11.

Paris

White

Collins

. Catheter-based therapy of common femoral artery atherosclerotic disease. Vasc Med. 2011;16(2):109–112.

12.

Baumann

Ruch

Willenberg

. Endovascular treatment of common femoral artery obstructions. J Vasc Surg. 2011;53(4):1000–1006.

13.

Cotroneo

Iezzi

. The role of “cutting” balloon angioplasty for the treatment of short femoral bifurcation steno-obstructive disease. Cardiovasc Intervent Radiol. 2010;33(5):921–928.

14.

Silva

White

Quintana

Collins

Jenkins

Ramee

. Percutaneous revascularization of the common femoral artery for limb ischemia. Catheter Cardiovasc Interv. 2004;62(2):230–233.

15.

Stricker

Jacomella

. Stent-assisted angioplasty at the level of the common femoral artery bifurcation: midterm outcomes. J Endovasc Ther. 2004;11(3):281–286.

16.

Kechagias

Ylönen

Biancari

. Long-term outcome after isolated endarterectomy of the femoral bifurcation. World J Surg. 2008;32(1):51–54.

17.

Herisson

Heymann

Chétiveaux

. Carotid and femoral atherosclerotic plaques show different morphology. Atherosclerosis. 2011;216(2):348–354.

18.

Laird

. Endovascular treatment of common femoral artery disease viable alternative to surgery or just another short-term fix. J Am Coll Cardiol. 2011;58(8):799–800.

19.

Rosenfield

Schainfeld

Pieczek

Haley

Isner

. Restenosis of endovascular stents from stent compression. J Am Coll Cardiol. 1997;29(2):328–338.

20.

Andrews

Venbrux

Magee

Bova

. Placement of a flexible endovascular stent across the femoral joint: an in vivo study in the swine model. J Vasc Interv Radiol. 1999;10(9):1219–1228.

21.

Dosluoglu

Lall

Cherr

Harris

Dryjski

. Role of simple and complex hybrid revascularization procedures for symptomatic lower extremity occlusive disease. J Vasc Surg. 2010;51(6):1425–1435.e1.

22.

Nishibe

Kondo

Dardik

Muto

Koizumi

Nishibe

. Hybrid surgical and endovascular therapy in multifocal peripheral TASC D lesions: up to three-year follow-up. J Cardiovasc Surg (Torino). 2009;50(4):493–499.