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Endovascular approach for common femoral artery disease valid alternative to surgery
Bovini R. J Am Coll Cardiol. 2011;58:792-798.
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The use of balloon angioplasty and provisional stenting for the treatment of common femoral artery disease yielded a high success rate and a low rate of in-hospital complications, according to study results.
Looking at data collected between September 1996 and December 2007, researchers examined 360 common femoral artery (CFA) interventions performed in 321 patients, with balloon angioplasty performed as the primary intervention in 98.6% of the cases. Stenting was required in 36.9% of the procedures because of suboptimal angioplasty results, and was “associated with a better patency rate compared with that of balloon angioplasty alone.” Failures in these procedures were observed in 7.2% of patients.
On the other hand, while surgery had virtually a 100% success rate and positive long-term outcomes in CFA, surgery-related morbidity persisted and was “not negligible.” According to researchers, “major hematoma, wound infection, nerve damage with persistent sensory disturbances, and the need for surgical revision may occur in up to 5% of cases, and the incidence of minor complications such as seromas and hematomas may be as high as 20%.”
The researchers also said that although surgery is used more often than endovascular treatments for CFA, endovascular treatments can be just as effective as surgery.
“Although percutaneous treatment has been accepted as the preferred initial revascularization strategy for the majority of atherosclerotic obstructions in the lower limb, CFA disease remains a mainly surgical domain because it is easily accessible and endarterectomy is associated with favorable long-term outcomes,” the researchers concluded. “In the last few years, the improvements in endovascular equipment and the technical skills of operators have led to an increasing number of percutaneous CFA interventions.”
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