Stent-Assisted Angioplasty at the Level of the Common Femoral Artery Bifurcation: Midterm Outcomes

Abstract

Purpose:

To report the midterm outcome after stent-assisted angioplasty of occlusive disease at the common femoral artery bifurcation.

Methods:

Between 1995 and 2002, 27 consecutive patients (18 men; mean age 70 years, range 47–90) underwent angioplasty with stent implantation in 33 limbs; target sites included 19 common femoral arteries, the origins of 2 superficial or 4 profunda femoris arteries, and 8 bypass anastomoses.

Results:

Technical success was 100%. Patients were followed for a mean 30 months (95% CI 21 to 39), at which time the cumulative primary patency was 86% (95% CI 85% to 88%). At 3 years, 83% of the arteries were patent. Five restenoses were due to neointimal hyperplasia in 4 cases (3 bypass grafts) and strut failure of the only balloon-expandable stent used in this series. Restenoses due to neointimal hyperplasia at bypass anastomoses (3/8) were more common than in native arteries (2/25) (p=0.078); cumulative primary patency for the bypass subgroup was 71% (95% CI 59% to 82%) at a mean 23-month follow-up; 75% and 60% of the anastomoses were patent after 1 and 2 years, respectively.

Conclusions:

Angioplasty of obstructions in the common femoral artery and its bifurcation with implantation of self-expanding stents shows good midterm primary patency. Native artery lesions have a better outcome than stenoses at bypass anastomoses. The procedure does not preclude further endovascular interventions at the puncture site.