Original title: Acute and Medium-Term Outcomes of Endovascular Therapy of Obstructive Disease of Diverse Etiology of the Common Femoral Artery. Reference: Philip B. Dattilo et al. Catheterization and Cardiovascular Interventions 81:1013–1022 (2013).
Surgical endarterectomy is established as the gold standard for treating injuries to common femoral artery since angioplasty presents some difficulties due to the risk of compromising the deep femoral artery or the physical forces to which it is subjected when segmenting a stent. Despite the above, there are emerging studies supporting angioplasty as an alternative to surgery.
This study included 30 patients of whom 22 had chronic atherosclerotic lesions and 8 acute ischemia due to complications from access by percutaneous closure devices. The overall technical success in this cohort was 90% (given the inability to cross the lesion in 3 patients who were eventually referred for surgery). A stent was used in only one patient, with the initial intention to only perform balloon angioplasty combined with different atherectomy devices. The primary and secondary patency at two years follow-up was 83% ± 8% and 86% ± 7%, respectively. All those who showed restenosis had originally developed atherosclerotic lesions.
Conclusion:
In this series of consecutive patients with injury to the common femoral artery of various etiologies, balloon angioplasty combined with atherectomy devices had acceptable results without stent implants or deep femoral compromise. The excellent primary patency observed in patients with injuries due to the use of percutaneous closure devices suggests endovascular treatment as the first option for this group of patients.
Commentary:
The ability to successfully resolve our own complications, such as those associated with percutaneous closure device, is good news. However, angioplasty for atherosclerotic lesions in the common femoral artery should still be reserved for patients with contraindications to surgery.
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