Endovascular management of the arteria profunda femoralis: long-term angiographic and clinical outcomes

Cardiovasc Intervent Radiol. 2012 Oct;35(5):1016-22. doi: 10.1007/s00270-011-0284-x. Epub 2011 Oct 7.

Abstract

Purpose: This study was designed to investigate the long-term angiographic and clinical outcomes of percutaneous transluminal angioplasty (PTA) of the arteria profunda femoralis (PFA), in a series of patients suffering from critical limb ischemia (CLI) or severe intermittent claudication (IC).

Methods: Our department's database was searched to identify patients who underwent PTA or bail-out stenting of the PFA. Among the study's inclusion criteria were Rutherford categories 3-6 and ≥70% stenosis of the PFA. Only de novo stenotic lesions were assessed. Primary endpoints were technical success, angiographic lesion primary patency, angiographic binary in-lesion restenosis, and target lesion recanalization (TLR) rates. Secondary endpoints included patient survival, limb salvage, and complication rates. Patient's baseline demographics, lesion, and procedural details were analyzed.

Results: Between 2001 and 2011, 20 consecutive patients (17 males) with a mean age of 73 ± 9 (range 53-87) years underwent PTA or bail-out stenting in 23 PFA lesions. Critical limb ischemia was the indication in eight of 20 patients (40%). The mean lesion length was 31 ± 9.5 mm. The procedural technical success was 100% (23/23), whereas mean time angiographic and clinical follow-up was 26.8 ± 24.6 months. According to the Kaplan-Meier analysis, primary patency and binary restenosis rate were 95 and 86.1% respectively up to 8 years follow-up. No TLR procedures were performed. The 8-year patient survival and limb salvage rates were 87.5 and 84.7% respectively.

Conclusions: PTA or stenting of focal, stenotic, PFA lesions, in patients suffering from CLI or IC, exhibit high long-term primary patency rates, as well as low binary restenosis and TLR rates. Large, multicenter studies are required to validate these results.

MeSH terms

  • Aged
  • Angiography
  • Angioplasty, Balloon*
  • Anticoagulants / therapeutic use
  • Comorbidity
  • Female
  • Femoral Artery / diagnostic imaging
  • Femoral Artery / pathology
  • Femoral Artery / surgery*
  • Humans
  • Intermittent Claudication / diagnostic imaging
  • Intermittent Claudication / surgery*
  • Ischemia / diagnostic imaging
  • Ischemia / surgery*
  • Leg / blood supply*
  • Limb Salvage
  • Male
  • Statistics, Nonparametric
  • Stents*
  • Survival Rate
  • Treatment Outcome
  • Vascular Patency

Substances

  • Anticoagulants