Atherectomy and Intravascular Lithotripsy Provide Comparable Outcomes for Common Femoral Artery Atherosclerotic
Nicolas Bouchareine1, Guillaume Daniel1, Sonia Ramos-Pascual2
1Clinique Trénel, Sainte-Colombe, France.
Summary
Atherectomy and intravascular lithotripsy (IVL) show similar short- to mid-term success for common femoral artery (CFA) atherosclerosis treatment. Both procedures offer comparable technical success, limb salvage, and freedom from target lesion revascularization, aiding clinical decisions.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Endovascular Therapy
Background:
- Common femoral artery (CFA) atherosclerosis significantly impacts patient mobility and quality of life.
- Endovascular interventions like atherectomy and intravascular lithotripsy (IVL) are increasingly used for CFA disease.
- Comparative outcome data for these treatments in symptomatic CFA atherosclerosis are crucial for clinical decision-making.
Purpose of the Study:
- To systematically review and meta-analyze studies on atherectomy and/or IVL for symptomatic CFA atherosclerosis.
- To critically appraise the published evidence on the outcomes of these endovascular treatments.
- To provide evidence-based support for clinicians managing CFA atherosclerosis.
Main Methods:
- Systematic review and meta-analysis adhering to PRISMA guidelines, registered in PROSPERO.
- Searched MEDLINE and Embase for studies published between 2000 and 2023 on atherectomy and/or IVL in symptomatic CFA atherosclerosis.
- Extracted data on study/lesion characteristics and clinical/technical outcomes; assessed risk of bias using the Mixed Methods Appraisal Tool (MMAT).
Main Results:
- Sixteen studies (960 limbs for atherectomy, 66 limbs for IVL) were included.
- Both atherectomy and IVL demonstrated high technical success (96% vs. 97%), similar bailout stenting rates (6% vs. 8%), freedom from target lesion revascularization (90% vs. 91%), and limb salvage (97% vs. 95%).
- Intravascular lithotripsy (IVL) showed a trend towards more perioperative complications (16% vs. 10% for atherectomy).
Conclusions:
- Atherectomy and IVL offer comparable short- to mid-term outcomes for symptomatic CFA atherosclerosis.
- The choice between atherectomy and IVL may be at the clinician's discretion based on current evidence.
- Further research with longer follow-up periods is necessary to establish definitive clinical recommendations.
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