Kugler Nathan W
Division of Vascular and Endovascular Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
Semin Intervent Radiol. 2023 Jun 16;40(2):156-160. doi: 10.1055/s-0043-57262. eCollection 2023 Apr.
Common femoral artery disease is at the heart of nearly all treatment algorithms and decisions for patients with symptomatic peripheral arterial disease. Surgical endarterectomy has been the mainstay of common femoral treatment with a wealth of data supporting its safety, efficacy, and durability. Advances in endovascular technology and techniques for the management of iliac and superficial femoral artery disease has resulted in a paradigm shift in management. The common femoral artery has been aptly named a "no stent zone" due to anatomic and disease-specific challenges that have limited the role for endovascular techniques. New technology and techniques in the endovascular management of common femoral disease seek to change our treatment strategies. A multimodal approach utilizing a combination of angioplasty, atherectomy, and stenting has been shown most beneficial, although limited long-term data leave durability an unanswered question. While surgical treatment remains the gold standard, advances in the endovascular approach will certainly continue to improve outcomes. As truly isolated common femoral disease is a rarity, a collaborative approach combining all benefits of open and endovascular techniques in the treatment of peripheral arterial disease is essential.
股总动脉疾病是几乎所有有症状外周动脉疾病患者治疗方案和决策的核心。外科内膜切除术一直是股总动脉治疗的主要方法，大量数据支持其安全性、有效性和持久性。髂动脉和股浅动脉疾病管理的血管内技术和技巧的进步导致了治疗模式的转变。由于解剖学和疾病特异性挑战限制了血管内技术的作用，股总动脉被恰当地称为“无支架区域”。股总动脉疾病血管内管理的新技术和技巧试图改变我们的治疗策略。尽管长期数据有限，耐久性仍是一个未解决的问题，但采用血管成形术、斑块旋切术和支架置入术相结合的多模式方法已被证明是最有益的。虽然手术治疗仍然是金标准，但血管内治疗方法的进步肯定会继续改善治疗效果。由于真正孤立的股总动脉疾病很少见，因此在治疗外周动脉疾病时，将开放手术和血管内技术的所有优点结合起来的协作方法至关重要。
