Endovascular Treatment of Common Femoral Artery Disease Studied

August 15, 2011—In the Journal of the American College of Cardiology, Robert F. Bonvini, MD, et al published findings from a study that sought to evaluate the technical feasibility, safety, and 1-year efficacy of the endovascular treatment of atherosclerotic common femoral artery (CFA) obstructions, a known cause of symptomatic peripheral arterial disease (2011;58:792–798). The investigators noted that although surgical endarterectomy is considered the therapy of choice for this condition, little is known about the percutaneous options.

As detailed in the Journal of the American College of Cardiology, the investigators used a prospectively maintained single-center database to retrospectively analyze the outcomes of 360 consecutive percutaneous interventions of the CFA for atherosclerotic disease. They assessed procedural success, in-hospital complications, and 1-year patency and target lesion revascularization rates. The investigators reported that 97 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%).

According to the investigators, 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 (ie, requiring surgery) and minor (ie, treated percutaneously or conservatively) complications occurred in 5 (1.4%) and 18 (5%) procedures, respectively. One-year follow-up data were available for 281 patients (87.5%). The investigators observed restenosis > 50% by duplex scanning and target lesion revascularization in 74 of 268 (27.6%) and 64 of 322 (19.9%) procedures, respectively.

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