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Updated: Dec 29, 2025

Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
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Directional Atherectomy of the Common Femoral Artery: Complications and Outcomes

Fernando Picazo1, Ricky C H Kwok1, Joseph A Hockley1

  • 1Department of Vascular and Endovascular Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.

Annals of Vascular Surgery
|February 9, 2020
PubMed

Insights

Directional atherectomy (DA) with drug-coated balloons (DCB) shows promise for common femoral artery (CFA) occlusive disease. Initial results indicate safety and effectiveness, with high patency rates and manageable complications.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Endovascular Therapy

Background:

  • Common femoral artery (CFA) occlusive disease management often involves minimally invasive techniques.
  • Directional atherectomy (DA) with or without drug-coated balloons (DCB) offers advantages like early mobilization and reduced complications.
  • However, DA has recognized complications, potentially linked to the learning curve.

Purpose of the Study:

  • To present initial experience with DA for CFA occlusive disease.
  • To suggest practice-based improvements for better outcomes.
  • To evaluate the safety and efficacy of DA with/without DCB in CFA treatment.

Main Methods:

  • Retrospective analysis with prospective data collection from two centers.
  • Inclusion of 25 consecutive patients undergoing CFA DA with/without DCB for >70% stenosis.
  • Primary endpoints: technical success, primary patency, morbidity, mortality. Secondary endpoints: Rutherford-Becker class, length of stay, revascularization rate.

Main Results:

  • 25 patients underwent CFA DA; 23 had >70% stenosis.
  • No 30-day deaths. Complications: 2 pseudoaneurysms, 1 perforation (all managed).
  • 100% primary and secondary patency at 3-6 months, 96% at 12 months. Mean LOS 1.9 days.

Conclusions:

  • CFA DA with/without DCB appears safe and effective in early outcomes.
  • Pre-procedural imaging (CTA, USS) may help minimize risks like pseudoaneurysm or perforation.
  • Procedural experience is crucial for preventing long-term complications like localized dilatation.
Abstract

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