Results of common femoral artery thromboendarterectomy evaluation of a traditional surgical management in the endovascular era

Wieker, Carola Marie; Schönefeld, Eva; Osada, Nani; Lührs, Christina; Beneking, Roland; Torsello, Giovanni; Böckler, Dittmar

doi:10.1016/j.jvs.2016.04.036

Cited by 45 publications

(45 citation statements)

References 14 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%

“…The cumulative rate of wound infection was 5·9 (95 per cent c.i. 3·4 to 9·0) per cent (9 studies, 3035 procedures), and that for lymph leak was 5·7 (3·3 to 8·6) per cent (11 studies, 1567 procedures); 0·8 per cent of procedures (15 of 1843) involved delayed wound healing or wound dehiscence (registry study) ( Table ).…”

Section: Resultsmentioning

confidence: 99%

“…The cumulative risk across all studies (two RCTs and 20 case series) was similar for endovascular procedures (2·7 (95 per cent c.i. 1·2 to 4·8) per cent; 7 studies, 381 procedures) and CFE (1·9 (0·7 to 3·8) per cent; 14 studies, 1508 procedures).…”

Section: Resultsmentioning

confidence: 99%

“…The cumulative rate of wound infection was 5⋅9 (95 per cent c.i. 3⋅4 to 9⋅0) per cent (9 studies 3,6,19,29,32,37,38,42,45,46 , 3035 procedures), and that for lymph leak was 5⋅7 (3⋅3 to 8⋅6) per cent (11 studies 6,30,31,34,37,38,40,41,43,45,46 , 1567 procedures); 0⋅8 per cent of procedures (15 of 1843) involved delayed wound healing or wound dehiscence (registry study 3,18 ) ( Table 3). Two CFA stent fractures and one CFA stent deformity were reported in three studies 6,27,28 .…”

Section: Safetymentioning

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%