Pure Endovascular versus Hybrid Approach for Management of Iliofemoral Arterial Disease: A Randomized Controlled...

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Endovascular Interventions

Background:

• Common femoral artery (CFA) atherosclerotic lesions present challenges for endovascular repair adoption.
• Surgical treatment remains the standard due to accessibility and long-term outcomes.
• Recent advancements in endovascular technology are increasing percutaneous CFA procedures.

Purpose of the Study:

• To evaluate the safety and efficacy of endovascular approaches for CFA disease.
• To compare the SUPERA stent versus a hybrid technique for treating CFA stenotic or occlusive lesions.

Main Methods:

• A single-center, randomized prospective study included 36 patients with symptomatic CFA lesions (Rutherford 2-4).
• Patients were randomized to either the SUPERA stent group or a hybrid technique group.
• Outcomes assessed included clinical symptom improvement, pulse restoration, vessel patency, reocclusion, and restenosis.

Main Results:

• 88.9% of patients reported improved clinical symptoms, and 87.5% had restored pulse and patent vessels postoperatively.
• No reocclusion or restenosis was observed during the follow-up period.
• The hybrid technique demonstrated a statistically significant greater reduction in peak systolic velocity ratio (PSVR) compared to the SUPERA group (p < 0.0001).

Conclusions:

• Endovascular treatment of CFA disease using the SUPERA stent in experienced hands is safe and feasible.
• Both SUPERA stent and hybrid techniques show favorable outcomes with low morbidity and mortality.
• The hybrid technique may offer superior hemodynamic improvement in PSVR postintervention.