Bahaa Nasr1, Nellie Della Schiava2, Fabien Thaveau3, Eugenio Rosset4, Jean-Pierre Favre5, Lucie Salomon du Mont6, Jean-Marc Alsac7, Réda Hassen-Khodja8, Thierry Reix9, Eric Allaire10, Eric Ducasse11, Raphael Soler12, Béatrice Guyomarc'h13, Yann Gouëffic14. 1. CHU Brest, service de chirurgie vasculaire, Brest, France. 2. Hôpital Edouard Herriot, service de chirurgie vasculaire, Lyon, France. 3. CHU Strasbourg, Nouvel Hôpital Civil, service de chirurgie vasculaire, Strasbourg, France. 4. CHU Clermont-Ferrand, Hôpital Gabriel Montpied, service de chirurgie vasculaire, Clermont-Ferrand, France. 5. CHU St-Etienne, Hôpital Nord, service de chirurgie vasculaire, Saint Etienne, France. 6. CHU Besançon, Hôpital Jean Minjoz, service de chirurgie vasculaire, Besançon, France. 7. AP-HP, Hôpital Européen Georges Pompidou, service de chirurgie cardiovasculaire, Paris, France. 8. CHU Nice, Hôpital Saint Roch, service de chirurgie vasculaire, Nice, France. 9. CHU Amiens, Hôpital Sud, service de chirurgie vasculaire, Amiens, France. 10. AP-HP, Hôpital Henri Mondor, service de chirurgie vasculaire, Créteil, France. 11. CHU Bordeaux, Hôpital Pellegrin, service de chirurgie vasculaire, Bordeaux, France. 12. AP-HM, Hôpital La Timone, service de chirurgie vasculaire, Marseille, France. 13. CHU Nantes, institut du thorax, INSERM, CNRS, UNIV Nantes, Nantes, France. 14. Hôpital Paris Saint Joseph, service de chirurgie vasculaire et endovasculaire, Paris, France; Laboratoire de Physiopathologie de la Résorption Osseuse, Inserm-UN UMR-957, Nantes, France. Electronic address: ygoueffic@hpsj.fr.
Abstract
BACKGROUND:Common femoral artery (CFA) stenting appears as a promising alternative treatment to the open surgery for de novo CFA stenosis. The stenting of lesions just located at the CFA is simple, whereas stenting of CFA bifurcation lesions is more complex, and outcomes are still matter of debate. The aim of this study was to describe and to compare clinical outcomes of techniques used to treat simple over complex lesions for the stenting of CFA lesions. MATERIALS/ METHODS: From the French randomized controlled trial, TECCO, a total of 54 patients underwentstenting intervention and were enrolled in this study. Patients were excluded if they had CFA thrombosis, restenosis, and nonatheromatous lesions. Patients were classified by simple and complex lesions based on the type of lesion. The primary end point was the primary sustained clinical improvement. RESULTS:Eighteen patients were included in the simple lesion group, and 36 patients, in the complex lesion group. Baseline characteristics of patients were comparable between the 2 groups. The technical success was 100% in the simple lesion group and 91.7% in the complex lesion group. There was no significant difference between the 2 groups, regarding the primary sustained clinical improvement. The primary patency rates at 24 months for simple and complex lesion groups were 86.3% and 79%, respectively (P = 0.66). Freedom from target lesion revascularization was of 93.3% and 82% in the simple and complex lesion group, respectively (P = 0.34). CONCLUSIONS: The stenting technique for CFA bifurcation lesions is a safe and effective technique. More trials with a large number of patients are needed to define the optimal stenting technique.
RCT Entities:
BACKGROUND: Common femoral artery (CFA) stenting appears as a promising alternative treatment to the open surgery for de novo CFA stenosis. The stenting of lesions just located at the CFA is simple, whereas stenting of CFA bifurcation lesions is more complex, and outcomes are still matter of debate. The aim of this study was to describe and to compare clinical outcomes of techniques used to treat simple over complex lesions for the stenting of CFA lesions. MATERIALS/ METHODS: From the French randomized controlled trial, TECCO, a total of 54 patients underwent stenting intervention and were enrolled in this study. Patients were excluded if they had CFA thrombosis, restenosis, and nonatheromatous lesions. Patients were classified by simple and complex lesions based on the type of lesion. The primary end point was the primary sustained clinical improvement. RESULTS: Eighteen patients were included in the simple lesion group, and 36 patients, in the complex lesion group. Baseline characteristics of patients were comparable between the 2 groups. The technical success was 100% in the simple lesion group and 91.7% in the complex lesion group. There was no significant difference between the 2 groups, regarding the primary sustained clinical improvement. The primary patency rates at 24 months for simple and complex lesion groups were 86.3% and 79%, respectively (P = 0.66). Freedom from target lesion revascularization was of 93.3% and 82% in the simple and complex lesion group, respectively (P = 0.34). CONCLUSIONS: The stenting technique for CFA bifurcation lesions is a safe and effective technique. More trials with a large number of patients are needed to define the optimal stenting technique.