Angioplasty of the Common Femoral Artery and Its Bifurcation

Thiney, Pierre-Olivier; Millon, Antoine; Boudjelit, Tarek; Schiava, Nellie Della; Feugier, Patrick; Lermusiaux, Patrick

doi:10.1016/j.avsg.2015.02.001

Cited by 51 publications

(47 citation statements)

References 30 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. 2019

Journal of British 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. 2019

Journal of British Surgery

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“…16 Recently, Thiney et al reported that, at a mean follow-up of 24 months, the rates of restenosis, TLR, and stent fracture were 7%, 4% and 9%, respectively, in 53 CFA lesions treated with EVT including 50 that underwent primary stenting. 15 CFA stenting might decrease the rate of restenosis and TLR, but it does not necessarily deliver long-term patency because stent fractures may increase over time. Reocclusion of the CFA and its bifurcation can cause severe limb ischemia.…”

Section: Kuma S Et Almentioning

confidence: 99%

“…Indeed, the major amputation rate of claudication and CLI groups was 3% and 13%, respectively. 15 Furthermore, CFA stenting can cause potential complications for subsequent surgical conversion: stent implantation means that subsequent surgery requires longer dissection and arteriotomy, and more complicated procedures for processing the CFA branches. There are few reports on the long-term results of EVT for the CFA; Soga et al reported that the 1-and 5-year primary patency rates were 73.5% and 46.9% in 111 CFA lesions treated with EVT, 17 which is not promising.…”

Section: Kuma S Et Almentioning

confidence: 99%

Clinical Outcome of Surgical Endarterectomy for Common Femoral Artery Occlusive Disease

Kuma

Tanaka

Ohmine

et al. 2016

Circ J

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“…Oneyear primary patency rates were from 80% to 87%, and at the 2-year follow-up, one study found the primary patency rate to be 83%. 21,22 Thiney et al 23 reported a single center study, 2-year primary patency rate of 92.5%, and Nasr et al 24 1-year primary patency of 88.6% in these subjects. These results suggest that stenting may produce favorable patency results that are better than PTA alone.…”

Section: Intravascular Stent Implantationmentioning

confidence: 90%

“…Similarly, minor complications typically consisted of small hematomas, arteriovenous fistulas, creatinine elevation, and small distal embolizations that could be managed conservatively and without need for re‐intervention. Endovascular CFA revascularization also shows a shorter length of stay ranging from 2.1 to 3.2 days, compared to 3.2 to 6.3 days length of stay for open CFA repair . With fewer complications and requiring a shorter length of hospitalization, the use of endovascular intervention aligns with the cost‐conscious, patient‐centric approach of today's healthcare.…”

Section: Complications Of the Endovascular Approachmentioning

confidence: 92%

Management of common femoral artery occlusive disease: A review of endovascular treatment strategies and outcomes

Wong

Lahsaei

Aoun

et al. 2018

Cathet Cardio Intervent

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Isolated atherosclerotic lesions of the common femoral artery (CFA) are rare but can produce significant claudication and critical limb ischemia. To date, the “gold standard” treatment for this entity has been common femoral endarterectomy (CFE) with or without patch angioplasty. However, surgery does have significant early postoperative complications, with a 15% combined mortality/morbidity. This manuscript sought to perform a comprehensive review of all studies and available data on endovascular treatment of isolated CFA disease and compare its utility to the traditional gold standard treatment. Twenty‐one studies from 1987 to 2018 were included exploring the various CFA endovascular therapies (percutaneous transluminal angioplasty, intravascular stenting, drug‐coated balloons, and directional atherectomy employed to treat CFA disease, in terms of efficacy, safety, and complications). As a conclusion, endovascular interventions provide acceptable short‐term technical outcomes for CFA disease while limiting procedural complications. While only two randomized controlled trials compare short and long‐term outcomes of surgical versus endovascular treatment, further studies are required to clarify the role of endovascular therapy.

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Angioplasty of the Common Femoral Artery and Its Bifurcation

Cited by 51 publications

References 30 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

Clinical Outcome of Surgical Endarterectomy for Common Femoral Artery Occlusive Disease

Management of common femoral artery occlusive disease: A review of endovascular treatment strategies and outcomes

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