Angioplasty and provisional stent treatment of common femoral artery lesions.
OBJECTIVE
Isolated atherosclerotic common femoral artery (CFA) disease is a rare cause of symptomatic peripheral arterial disease. Although surgical endarterectomy is considered the therapy of choice, little is known about outcomes of percutaneous treatment.


METHODS
A prospectively maintained single-center database was retrospectively analyzed for outcomes of consecutive patients undergoing isolated percutaneous revascularization of CFA disease between 1996 and 2007. In all cases, the intended strategy was balloon angioplasty with provisional stent placement in case of poor angioplasty results. Among 516 consecutive procedures involving the CFA, 419 were excluded because of nonatherosclerotic disease (n = 156) or treatment of additional vascular segments during the same procedure (n = 263). Procedural success (ie,<30% residual stenosis), in-hospital vascular complications (major [requiring surgical or percutaneous treatment] or minor [treated conservatively]), and 12-month restenosis and target lesion revascularization (TLR) rates were assessed for the remaining 97 interventions.


RESULTS
CFA bifurcation lesions were present in 40 cases (41.2%) and required treatment of the deep femoral artery in 25 (25.8%). Chronic total CFA occlusions accounted for 11 cases (11.3%). Balloon angioplasty was performed in 96 cases (98.9%), and provisional stent placement was necessary in 37 (38.1%). The procedure was successful in 89 cases (91.8%). Minor and major vascular complications at 30 days occurred in three (3.1%) and four (4.1%) cases, respectively. At 12 months, restenosis greater than 50% and TLR were observed in 19.5% and 14.1% of procedures, respectively.


CONCLUSIONS
This series shows that isolated CFA lesions may be safely and efficaciously treated with angioplasty and provisional stent placement.
North County Radiology Medical Group, RRS, 3156 Vista Way, Suite 100, Oceanside, CA 92056, USA. robert.bonvini@hcuge.ch
Robert F
RF
Bonvini
Aljoscha
A
Rastan
Sebastian
S
Sixt
Ulrich
U
Beschorner
Elias
E
Noory
Thomas
T
Schwarz
Marco
M
Roffi
Pierre-André
PA
Dorsaz
Uwe
U
Schwarzwälder
Karlheinz
K
Bürgelin
Roland
R
Macharzina
Thomas
T
Zeller
D000368:Aged; D017130:Angioplasty / Q000706:statistics & numerical data*; D001807:Blood Vessel Prosthesis; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D015897:Comorbidity; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000517:prevention & control; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents / Q000706:statistics & numerical data*; D013557:Switzerland / Q000453:epidemiology; D016896:Treatment Outcome