scholarly journals Repair of integrity of the common femoral artery after endovascular interventions

2018 ◽  
Vol 26 (4) ◽  
pp. 81-88
Author(s):  
O.A. Vlasenko ◽  
◽  
S.M. Furkalo ◽  
I.V. Khasyanova ◽  
V.A. Kondratiuk ◽  
...  
Vascular ◽  
2016 ◽  
Vol 24 (4) ◽  
pp. 404-413 ◽  
Author(s):  
Jonathan Bath ◽  
Efthymios Avgerinos

Background Atherosclerotic disease of common femoral and profunda femoris arteries has been historically treated with surgical endarterectomy. Endovascular treatment of common femoral artery and profunda femoris artery disease is increasingly reported in the recent literature. This review summarizes short- and mid-term outcomes of endovascular interventions to the common femoral artery and common femoral artery. Methods All published series in the English language were identified through a systematic PubMed search. Standard descriptive statistics, reported as mean ± SD, were applied to perform the pooled analysis and calculate the overall outcome measures. Combined overall effect sizes were calculated using fixed-effect meta-analysis. Results The analysis included 20 studies with a total of 836 patients (897 limbs, mean age of 70.5 ± 4.3 years, critical limb ischemia 39.6%). Technical success was 95%. Angioplasty alone was undertaken in 68.8% of cases and stenting in 22.3%. Access complications occurred in 2.4% of cases. Post-operative major adverse limb events occurred in 2% and major adverse cardiovascular events in 1% of cases. Primary patency at 6, 12 and 24 months was 87%, 77% and 73%, respectively. Subgroup analysis revealed a significantly higher mean primary patency at 12 months for routine stenting compared to a selective stenting strategy (91.4% versus 75%; p < 0.05). Conclusions Endovascular interventions to the common femoral artery and common femoral artery can be performed safely with high technical success. Endovascular therapy may be a favored approach over endarterectomy for highly selected patients of poor surgical risk, with limited life expectancy and those with wound-healing considerations such as re-operative fields or prone to infection.


2017 ◽  
Vol 51 (4) ◽  
pp. 220-227 ◽  
Author(s):  
David Halpin ◽  
Young Erben ◽  
Sasanka Jayasuriya ◽  
Bennett Cua ◽  
Sunny Jhamnani ◽  
...  

Objective: Common femoral endarterectomy (CFE) remains the standard of care for treatment of atherosclerotic stenosis of the common femoral artery (CFA). Endovascular interventions have become the first-line therapy for atherosclerotic disease of the aortoiliac and femoropopliteal systems. Recent reports have documented high rates of technical success and low rates of complications with endovascular management of CFA stenosis. This study is a contemporary review of the surgical and endovascular literature on the management CFA stenosis and compares the results of these methods. Methods: A search of OVID Medline identified all published reports of revascularization of isolated atherosclerotic CFA stenosis. For each study selected for review, the number of patients, number of limbs treated, percentage of patients with critical limb ischemia, and mean length of follow-up was recorded. Study end points included survival, primary patency, freedom from target lesion revascularization (TLR), freedom from amputation, and complications. Results: The review included 7 CFE studies and 4 endovascular studies. Survival was similar between the groups. Primary patency was consistently higher with CFE compared to endovascular therapy. Freedom from TLR was lower with CFE compared to endovascular therapy. Morbidity and mortality was also higher with CFE compared to endovascular therapy. Freedom from amputation was not consistently reported in the endovascular studies. Conclusion: There is limited data to support endovascular treatment of isolated CFA atherosclerosis. CFE has durable results, but there is significant morbidity and mortality resulting from this procedure. Endovascular interventions have low rates of complications, high rates of technical success, good short-term patency but increased need for repeat interventions when compared to surgery. Further trial data comparing CFE with endovascular therapy is needed to guide the management of CFA stenosis.


2020 ◽  
Vol 8 (4) ◽  
pp. 591-598
Author(s):  
R.E. Kalinin ◽  
◽  
I.A. Suchkov ◽  
E.A. Klimentova ◽  
I.N. Shanaev ◽  
...  

The deep femoral artery is a large branch of the common femoral artery that is of much interest for vascular and endovascular surgeons due to the role it plays in collateral circulation between the vessels of the small pelvis and arteries of the popliteal-tibial segment. In most cases, the deep femoral artery branches off from the posterolateral or posterior surface of the common femoral artery. At the same time, anomalies of development of the deep femoral vessels may become the cause for iatrogenic damages in implementation of the open or endovascular interventions. In the article, a clinical case of a patient referred for a planned ultrasound examination of vessels of the lower limbs before angiographic examination of the vessels of the heart and of the lower limbs, is described that revealed atypical topography of branching of the two trunks of the deep femoral artery from the common femoral artery. The upper trunk of the deep femoral artery branched off from the anteromedial surface of the common femoral artery and in the initial part was positioned above the common femoral vein. The lower trunk of the deep femoral artery sepa-rated from the anterolateral surface of the common femoral artery. Preoperative identification of the variant anatomy of the vessels of the femoral triangle permitted to perform angiographic examination of the coronary vessels through the femoral artery on the contralateral limb without complications.


2015 ◽  
Vol 29 (8) ◽  
pp. 1493-1500 ◽  
Author(s):  
Romain de Blic ◽  
Jean-François Deux ◽  
Hicham Kobeiter ◽  
Pascal Desgranges ◽  
Jean-Pierre Becquemin ◽  
...  

2012 ◽  
Vol 28 (5) ◽  
pp. 264-267 ◽  
Author(s):  
C Lekich ◽  
W Campbell ◽  
S Walton ◽  
P Hannah

Objectives: To discuss safety of EVLA in anomalies of the GSV anatomy. To review and discuss complications of surgery involving anomalous anatomy. Method: We report a case of high bifurcation of the common femoral artery wrapping around the saphenofemoral junction. Results: Successful ablation was achieved with no adverse consequences. Conclusion: EVLA is a safe treatment for SFJ/GSV incompetence in the presence of vascular anomalies that have historically resulted in serious vascular complications from surgery.


2006 ◽  
Vol 72 (9) ◽  
pp. 825-828 ◽  
Author(s):  
John D. Scott ◽  
David L. Cull ◽  
Corey A. Kalbaugh ◽  
Christopher G. Carsten ◽  
Dawn Blackhurst ◽  
...  

As patient longevity on hemodialysis has increased, surgeons are increasingly challenged to provide vascular access to patients who have exhausted options for access in the upper extremity. A common operation performed on these patients has been the loop thigh arteriovenous (AV) graft based off the common femoral vessels. However, there are several disadvantages of placing prosthetic grafts in proximity to the groin. Our group has modified the thigh loop AV graft procedure by moving the anastomoses to the mid-superficial femoral artery and vein. The advantage of this location is that it preserves the proximal femoral vessels for graft revision and avoids the node-bearing tissue and overhanging panniculus of the groin. The purpose of this study was to review our technique, patient selection, and experience with the mid-thigh loop AV graft procedure. Between 2001 and 2003, 46 mid-thigh loop AV grafts were placed in 38 patients. Patient hospital, office, and dialysis clinic records were reviewed. The primary and secondary patency for AV grafts in this study by life-table was 40 per cent and 68 per cent at 1 year and 18 per cent and 43 per cent at 2 years. There were 10 infections (21%) requiring graft removal. Four patients underwent subsequent placement of a proximal loop thigh AV graft after mid-thigh graft failure. Patient survival was 86 per cent at 1 year and 82 per cent at 2 years. There were no patient deaths related to thigh graft placement. Our results with the mid-thigh loop AV graft compare favorably with published results for thigh loop AV grafts. The procedure preserves the proximal vasculature, permitting graft revision or subsequent proximal graft placement, and may be associated with fewer infectious complications. The mid-thigh loop AV graft procedure should be considered before placement of a thigh loop AV graft based off the common femoral artery and vein.


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