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. 2011 Aug 16;58(8):792-8.
doi: 10.1016/j.jacc.2011.01.070.

Endovascular treatment of common femoral artery disease: medium-term outcomes of 360 consecutive procedures

Robert F Bonvini  1 , Aljoscha Rastan, Sebastian Sixt, Elias Noory, Thomas Schwarz, Ulrich Frank, Marco Roffi, Pierre André Dorsaz, Uwe Schwarzwälder, Karlheinz Bürgelin, Roland Macharzina, Thomas Zeller
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Free article

Endovascular treatment of common femoral artery disease: medium-term outcomes of 360 consecutive procedures

Robert F Bonvini et al. J Am Coll Cardiol. .
Free article

Abstract

Objectives: The purpose of this study was to evaluate the technical feasability, safety, and 1-year efficacy of the endovascular treatment of atherosclerotic common femoral artery (CFA) obstructions.

Background: Atherosclerotic CFA obstruction is a known cause of symptomatic peripheral arterial disease. Although surgical endarterectomy is considered the therapy of choice for this condition, little is known about the percutaneous options.

Methods: Using a prospectively maintained single-center database, we retrospectively analyzed the outcomes of 360 consecutive percutaneous interventions of the CFA for atherosclerotic disease and assessed procedural success, in-hospital complications, and 1-year patency and target lesion revascularization rates.

Results: Ninety-seven procedures (26.9%) were isolated CFA interventions, whereas 157 (43.6%) and 152 (42.2%) also involved inflow and outflow vessels, respectively. Bifurcation lesions were present in 140 cases (38.9%), and concomitant treatment of the profunda femoral artery was performed on 93 occasions (25.8%). Chronic total CFA occlusions were recanalized in 60 cases (16.7%). Balloon angioplasty was performed as the primary intervention in virtually all cases (98.6%), whereas stenting was needed for suboptimal angioplasty results in 133 procedures (36.9%). Failures-defined as a final angiographic result with a >30% residual stenosis-were observed on 26 occasions (7.2%). In-hospital major (i.e., requiring surgery) and minor (i.e., treated percutaneously or conservatively) complications occurred in 5 (1.4%) and 18 (5.0%) procedures, respectively. One-year follow-up data were available for 281 patients (87.5%). Restenosis >50% by duplex scanning and target lesion revascularization were observed in 74 of 268 (27.6%) and 64 of 322 (19.9%) procedures, respectively.

Conclusions: This large series suggests that the percutaneous approach may be a valid alternative to surgery for CFA atherosclerotic obstructions.

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