title: Combined use of directional atherectomy and drug-coated balloon for the endovascular treatment of common femoral artery disease: immediate and one-year outcomes.
abstract: OBJECTIVE
  Surgical endarterectomy is the therapy of choice for atherosclerotic common femoral artery (CFA) obstruction. Recently, some large single-centre series have shown encouraging results for the percutaneous treatment of CFA obstructions. The purpose of this study was to evaluate the safety, feasibility, and one-year efficacy of the endovascular treatment of CFA obstructions with combined use of directional atherectomy (DA) and a paclitaxel-coated balloon (DCB).
  
  
  RESULTS
  Between January 2012 and July 2014, 30 consecutive patients with severely calcified obstructions of the common femoral artery were treated in our centre using DA followed by DCB dilatation. Provisional stenting was allowed in the case of a suboptimal result. Twenty cases (66%) were isolated CFA interventions, whereas five (17%) and five (17%) also involved inflow and outflow vessels, respectively. Chronic total CFA occlusions (CTO) were recanalised in six cases (20%). Procedural success was achieved in all cases; stenting was needed in three cases (10%). At one year, restenosis and target lesion revascularisation were observed in two of 30 (6.6%) and one of 30 (3.3%) patients, respectively. The secondary patency rate was 96.7%.
  
  
  CONCLUSIONS
  This single-centre prospective study suggests that the combined use of DA and DCB is a safe and effective alternative to surgery, a treatment option for common femoral artery lesions and provides encouraging results in this setting.
authors.affiliation: Division of Invasive Cardiology, Montevergine Clinic, Mercogliano, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Cioppa
authors.forename: Eugenio
authors.initials: E
authors.lastname: Stabile
authors.forename: Luigi
authors.initials: L
authors.lastname: Salemme
authors.forename: Grigore
authors.initials: G
authors.lastname: Popusoi
authors.forename: Armando
authors.initials: A
authors.lastname: Pucciarelli
authors.forename: Fortunato
authors.initials: F
authors.lastname: Iacovelli
authors.forename: Antonella
authors.initials: A
authors.lastname: Arcari
authors.forename: Enrico
authors.initials: E
authors.lastname: Coscioni
authors.forename: Bruno
authors.initials: B
authors.lastname: Trimarco
authors.forename: Giovanni
authors.initials: G
authors.lastname: Esposito
authors.forename: Tullio
authors.initials: T
authors.lastname: Tesorio
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000379:methods; D017073:Atherectomy / Q000379:methods; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000628:therapy*; D011150:Popliteal Artery / Q000601:surgery; D011446:Prospective Studies; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency