title: Endovascular treatment of common femoral artery disease: medium-term outcomes of 360 consecutive procedures.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the technical feasability, safety, and 1-year efficacy of the endovascular treatment of atherosclerotic common femoral artery (CFA) obstructions.
  
  
  BACKGROUND
  Atherosclerotic CFA obstruction is a known cause of symptomatic peripheral arterial disease. Although surgical endarterectomy is considered the therapy of choice for this condition, little is known about the percutaneous options.
  
  
  METHODS
  Using a prospectively maintained single-center database, we retrospectively analyzed the outcomes of 360 consecutive percutaneous interventions of the CFA for atherosclerotic disease and assessed procedural success, in-hospital complications, and 1-year patency and target lesion revascularization rates.
  
  
  RESULTS
  Ninety-seven procedures (26.9%) were isolated CFA interventions, whereas 157 (43.6%) and 152 (42.2%) also involved inflow and outflow vessels, respectively. Bifurcation lesions were present in 140 cases (38.9%), and concomitant treatment of the profunda femoral artery was performed on 93 occasions (25.8%). Chronic total CFA occlusions were recanalized in 60 cases (16.7%). Balloon angioplasty was performed as the primary intervention in virtually all cases (98.6%), whereas stenting was needed for suboptimal angioplasty results in 133 procedures (36.9%). Failures-defined as a final angiographic result with a >30% residual stenosis-were observed on 26 occasions (7.2%). In-hospital major (i.e., requiring surgery) and minor (i.e., treated percutaneously or conservatively) complications occurred in 5 (1.4%) and 18 (5.0%) procedures, respectively. One-year follow-up data were available for 281 patients (87.5%). Restenosis >50% by duplex scanning and target lesion revascularization were observed in 74 of 268 (27.6%) and 64 of 322 (19.9%) procedures, respectively.
  
  
  CONCLUSIONS
  This large series suggests that the percutaneous approach may be a valid alternative to surgery for CFA atherosclerotic obstructions.
authors.affiliation: Angiology Division, Heart Center, Bad Krozingen, Germany. robert.bonvini@hcuge.ch
authors.forename: Robert F
authors.initials: RF
authors.lastname: Bonvini
authors.forename: Aljoscha
authors.initials: A
authors.lastname: Rastan
authors.forename: Sebastian
authors.initials: S
authors.lastname: Sixt
authors.forename: Elias
authors.initials: E
authors.lastname: Noory
authors.forename: Thomas
authors.initials: T
authors.lastname: Schwarz
authors.forename: Ulrich
authors.initials: U
authors.lastname: Frank
authors.forename: Marco
authors.initials: M
authors.lastname: Roffi
authors.forename: Pierre André
authors.initials: PA
authors.lastname: Dorsaz
authors.forename: Uwe
authors.initials: U
authors.lastname: Schwarzwälder
authors.forename: Karlheinz
authors.initials: K
authors.lastname: Bürgelin
authors.forename: Roland
authors.initials: R
authors.lastname: Macharzina
authors.forename: Thomas
authors.initials: T
authors.lastname: Zeller
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects; D001157:Arterial Occlusive Diseases / Q000209:etiology / Q000628:therapy*; D050197:Atherosclerosis / Q000150:complications / Q000628:therapy*; D005260:Female; D005263:Femoral Artery; D006801:Humans; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D015607:Stents; D014654:Vascular Patency