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Long-Term Outcomes of Common Femoral Artery Stenting
Bahaa Nasr1, Adrien Kaladji2, Pierre-Alexandre Vent3
1CHU de Brest, Service de Chirurgie cardiaque thoracique et Vasculaire, Brest, France.
Insights
Endovascular repair using stenting for common femoral artery (CFA) occlusive disease shows sustained clinical improvement over 5 years. This approach offers a viable treatment option, with concerns about stent fracture being minimal.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Endovascular Interventions
Background:
- Common femoral artery (CFA) occlusive disease impacts limb perfusion.
- Endovascular repair is an alternative to open surgery for CFA lesions.
Purpose of the Study:
- To evaluate the 5-year outcomes of endovascular repair for common femoral artery (CFA) occlusive disease.
Main Methods:
- 36 patients (40 limbs) underwent CFA stenting.
- Systematic 5-year follow-up with clinical exams and imaging.
- Prospective database maintained for data collection.
Main Results:
- 5-year mortality was 38%.
- Sustained clinical improvement at 3 and 5 years was 77% and 73%.
- Primary restenosis rate was 28%; deep femoral artery stenting and type III lesions predicted restenosis.
Conclusions:
- Endovascular repair of the CFA and its bifurcation yields durable clinical and morphological results.
- Concerns regarding stent fracture and hip mobility complications are largely unfounded.
Background:
The purpose of this study was to report the 5-year outcome relative to endovascular repair of the common femoral artery (CFA) for occlusive disease.
Methods:
Thirty-six consecutive patients (40 limbs) underwent stenting for CFA lesions. Patients were followed up systematically within a prospectively maintained database over 5 years. Follow-up included clinical examination, duplex scan, and biplane X-ray at 1, 6, 12 months and yearly thereafter.
Results:
Indications for endovascular repair of the CFA included 25 patients (70%) for claudication and 11 patients (30%) for critical limb ischemia. Mean follow-up was 64 months. Two patients were lost to follow-up. The mortality rate at 5 years was 38%. At 3 and 5 years, primary sustained clinical improvements were 77% and 73%, respectively. In-stent restenosis rate was 28%. The significant predictors of in-stent restenosis were deep femoral artery stenting (P = 0.0007) and type III lesions (P = 0.014). Freedom from target lesion revascularization and target extremity revascularization were 79% and 73%, respectively. One stent fracture was noted at the first year follow-up without clinical consequence, and no other stent fracture was noted during the remainder of the study.
Conclusions:
Endovascular repair of the CFA and its bifurcation seems to provide sustained clinical and morphological long-term results. Fear of stent fracture and local complications due to hip mobility are no longer relevant.
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