Abstract 4425: Common Femoral Artery Revascularization by Angioplasty With Stenting
INTRODUCTION Symptomatic atherosclerotic disease of the common femoral artery (CFA) is an uncommon clinical entity, with limited data in the literature addressing revascularization options for symptomatic lesions. This lesion is proximal to both the superficial femoral and profunda femoris arteries resulting in patients presenting with either claudication or critical limb ischemia. Given that catheter-based therapies have replaced conventional surgery as the first choice revascularization option in other peripheral vascular beds, the best treatment for symptomatic CFA lesions is uncertain. Management of CFA lesions by preserving vascular access is extremely important because the CFA is the most commonly used vascular access site.
METHODS We performed stent placement in 29 consecutive CFA lesions in 26 patients. Two-thirds (n=19) of the CFA lesions were stenoses, one quarter (n=7) were chronic occlusions, and 3 (10%) patients were treated with stents for vascular access bleeding complications. The indications for the procedure were Fontaine functional class IIa in 3 (10%) cases, IIb in 13 (45%) cases, 3 (10%) vascular access site complications, and critical limb ischemia in 10 (35%) cases.
RESULTS Angiographic success was obtained in 100% with complete resolution of clinical symptoms in 88% (23/26 limbs). Amputation-free survival at 30-day follow-up was 100%. At the last clinic visit (31±23 months), 27 of 29 (93%) limbs demonstrated sustained symptomatic improvement. Two patients had subsequent successful, uncomplicated CFA access traversing the implanted CFA stent.
CONCLUSION Our experience is consistent with several other investigators who have reported excellent safety and efficacy of catheter-based therapies for CFA lesions. Patients with vascular access complications, claudication and/or critical limb ischemia due to common femoral artery focal atherosclerotic stenosis or occlusion obtained an excellent procedural success with catheter-based therapy. Femoral vascular access was preserved, as we did not observe “jailed” vascular access. Treatment of a larger number of patients is warranted to confirm the utility and safety of catheter-based therapy for CFA disease as an alternative to conventional surgery.