Rassam Stephanie, Coscas Raphaël
Division of Vascular and Endovascular Surgery, Department of Heart, Vascular and Endovascular Surgery, Paracelsus Medical University, 5020 Salzburg, Austria.
Department of Vascular Surgery, Centre Hospitalier Universitaire Ambroise Paré, Assistance Publique Hôpitaux de Paris (AP-HP), 92104 Boulogne-Billancourt cedex, France.
J Clin Med. 2024 May 28;13(11):3169. doi: 10.3390/jcm13113169.
Occlusive lesions of the common femoral artery (CFA) and its bifurcation have traditionally been treated with open surgery. Although long-term patency rates after open surgery are excellent, such repairs are associated with substantial local and general morbidity. In recent years, different treatment options have emerged within percutaneous endovascular repair. We hereby present a narrative review on endovascular treatment modalities and a treatment algorithm for endovascular revascularisation of the CFA and its bifurcation. Lesion analysis, access issues, vessel preparation tools, and types of repairs with or without the involvement of the bifurcation are described. Based on current data, an interventional approach can result in high technical success and acceptable mid-term patency rates. Further comparative evidence with open surgery and/or between the different types of endovascular repairs is required to improve the current treatment algorithm.
股总动脉(CFA)及其分叉处的闭塞性病变传统上采用开放手术治疗。尽管开放手术后的长期通畅率很高,但此类修复与显著的局部和全身并发症相关。近年来,经皮血管腔内修复出现了不同的治疗选择。我们在此对血管腔内治疗方式以及CFA及其分叉处血管腔内血运重建的治疗算法进行叙述性综述。描述了病变分析、入路问题、血管准备工具以及涉及或不涉及分叉处的修复类型。基于当前数据,介入方法可带来较高的技术成功率和可接受的中期通畅率。需要进一步与开放手术进行比较的证据和/或不同类型血管腔内修复之间的比较证据,以改进当前的治疗算法。