Endovascular Treatment of the Common Femoral Artery for Limb Ischemia

Davies, Robert; Adair, William; Bolia, A.; Fishwick, Guy; Sayers, Robert D.; McCarthy, Mark J.

doi:10.1177/1538574413500723

Cited by 24 publications

(36 citation statements)

References 20 publications

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“…Cumulatively, wound haematoma occurred in 24 of 269 procedures (5·5 (95 per cent c.i. 0·2 to 17·2) per cent; 4 studies), similar to 35 of 1154 in the endarterectomy group (3·9 (1·7 to 6·9) per cent; 7 studies). No wound infection or lymph leak was reported in the endovascular group.…”

Section: Resultsmentioning

confidence: 78%

“…Only ten studies collected data prospectively, of which five reported endovascular intervention and five reported CFE. Less than half of the studies (11 of 28) had a sample size of greater than 100 and follow‐up of 1 year or more, of which four were in the endovascular group and seven were in the CFE group ( Table S6 , supporting information).…”

Section: Resultsmentioning

confidence: 99%

“…One RCT and six case series reported data on wound complications after endovascular intervention, with no complications observed in the RCT. Cumulatively, wound haematoma occurred in 24 of 269 procedures (5·5 (95 per cent c.i.…”

Section: Resultsmentioning

confidence: 99%

“…Results after 1 year were similar ( Table ). Duration of follow‐up for the four studies in the endovascular group was 18, 24, 28 and 49 months, and that for the seven case series in the CFE group was 16, 36, 39, 43, 60 (two studies) and 180 months. Unfortunately, revascularization was not reported in the RCTs.…”

Section: Resultsmentioning

confidence: 99%

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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: Resultsmentioning

confidence: 78%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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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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“…When combined with provisional stenting for suboptimal technical results, PTA is the most commonly used technique in the treatment of femoral popliteal disease. Review of the literature for CFA lesions treated with PTA alone reveals primary patency rates from 59% to 88% at 1 year and at 83% at 2 years . Available data on longer‐term patency of PTA for CFA lesions are more limited, describing primary patency rates of 66% and 60% at 4 and 5 years, respectively .…”

Section: Endovascular Therapies To Cfa Disease and Evidence For Theirmentioning

confidence: 99%

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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In the Patient with Profunda Artery Disease, Is Open Revascularization Superior to Endovascular Repair for Improving Rest Pain?

Stern

Bernhard

2017

Difficult Decisions in Surgery: An Evidence-Based Approach

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Endovascular Treatment of the Common Femoral Artery for Limb Ischemia

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

Cited by 24 publications

References 20 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

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

In the Patient with Profunda Artery Disease, Is Open Revascularization Superior to Endovascular Repair for Improving Rest Pain?

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