Management of Isolated Atherosclerotic Stenosis of the Common Femoral Artery: A Review of the Literature

Abstract

There is limited data to support endovascular treatment of isolated CFA atherosclerosis. CFE has durable results, but there is significant morbidity and mortality resulting from this procedure. Endovascular interventions have low rates of complications, high rates of technical success, good short-term patency but increased need for repeat interventions when compared to surgery. Further trial data comparing CFE with endovascular therapy is needed to guide the management of CFA stenosis.

Systematic review of endovascular intervention and surgery for common femoral artery atherosclerotic disease

“…More than 50 per cent of patients with PAD undergoing CFE require concomitant endovascular intervention (hybrid procedures) to diseased ipsilateral arteries. Two reviews previously concluded that endovascular interventions to CFA can be performed safely with a high rate of technical success. Since then, two RCTs and two case series on endovascular CFA treatment have been published.…”

Long-Term Outcome of Common Femoral Artery Endarterectomy In Octogenarians and Non-Octogenarians

“…However, the patient cohort was limited in both studies, and our operation time was similar. Endovascular therapy of the common femoral artery promises a low early mortality compared to surgical treatments (12). A database analysis including over 1000 patients who were treated by endovascular means showed a mortality of 1.6% within the first 30 days (16).…”

“…These findings correlated with other operative or endovascular treatments for peripheral arterial occlusion disease 22 . Patency rates for endovascular treatment of the common femoral artery are still sobering; 73% after 1 year are reported for primary patency 12,23 . Bath and Avgerinos 11 described a higher primary patency for routine stenting.…”

“…In addition, there is an ongoing debate regarding the treatment of the common femoral artery fueled by the advances in endovascular therapy. Advertised benefits are lower mortality and morbidity and a high technical success in endovascular treatment (11,12).…”

Contemporary critical limb ischemia: Asian multidisciplinary consensus statement on the collaboration between endovascular therapy and wound care

“…Although there is a tremendous advancement of procedural success of endovascular therapy, some experts might consider hybrid therapy with endovascular therapy and bypass surgery for complex lesions. In cases of common femoral artery disease involvement, hybrid therapy consisting of endovascular therapy and endarterectomy can be considered although percutaneous common femoral angioplasty might be technically feasible and durable in the short term [ 38 – 41 ].…”