Endovascular Intravascular Lithotripsy in the Treatment of Calcific Common Femoral Artery Disease: A Case Series With an 18-Month Follow-Up |
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| Affiliation: | 1. Department of Medicine, Division of Cardiology, Alpert Medical School of Brown University, The Miriam Hospital, Providence, RI, USA;2. Department of Medicine, Alpert Medical School of Brown University, Providence, RI, USA;3. Department of Medicine, Kent Hospital, RI, USA;4. Department of Medicine, Division of Cardiology, University of Kentucky College of Medicine, Bowling Green, KY, USA;5. Department of Medicine, Division of Cardiology, University of Toledo, OH, USA;1. Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, NE, United States of America;2. Department of Cardiology, Baystate Medical Center and University of Massachusetts School of Medicine, Springfield, MA, United States of America;1. University of Missouri - Columbia School of Medicine, Department of Medicine, Division of Cardiovascular Medicine, Columbia, MO, United States of America;2. Harry S. Truman Memorial Veterans'' Hospital, Department of Cardiology, Columbia, MO, United States of America;1. Endovascular Surgery Unit, Maria Cecilia Hospital, GVM Care & Research, Via Corriera, 1, Cotignola (RA), Emilia-Romagna, Italy;2. Vascular and Endovascular Surgery/Interventional Radiology, Associated Professor of the Universidade Federal do Vale do São Francisco – UNIVASF, Av. José de Sá maniçoba, s/n, Petrolina/PE 56304-917, Brazil;3. Diabetic Foot Department, Maria Cecilia Hospital, GVM Care & Research, Via Corriera, 1, Cotignola (RA), Emilia-Romagna, Italy |
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| Abstract: | BackgroundIntravascular lithotripsy (IVL) is a novel endovascular treatment for calcified common femoral artery disease (CFA). Data on midterm effectiveness for clinically driven target lesions revascularization (CD-TLR) is lacking. This study investigated CD-TLR during 18-month follow-up in patients requiring IVL for CFA disease treatment.MethodsIn a single-center retrospective cohort study, electronic medical record of patients undergoing IVL for CFA disease from January 2018 to March 2020 were reviewed. Primary outcome was CD-TLR estimated by Kaplan-Meier method during 18-month follow-up. Univariate logistic regression was used to compare differences in CD-TLR by the type of adjunct therapy used.ResultsAmong 54 CFA lesions in 50 patients, mean age (SD) was 75(8) years, gender and race were predominantly male (74%, n = 37) and white (94%, n = 47), respectively. Rutherford class III claudication was most common (70%, n = 35) with mean ABI of 0.66 (0.26) and mean angiographic stenosis of 77% (13%). Adjunct use of drug-coated balloon (DCB) angioplasty was 83% (n = 45) and atherectomy was 39% (n = 21). Residual angiographic stenosis was <30% in all cases. Complications included dissection requiring stent placement (2%, n = 1). After 18-months, 18% (n = 9) died unrelated to procedural complications and 6% (n = 3) were lost to follow-up. 18-month cumulative freedom from CD-TLR was 80.6% (95% CI: 69.1%, 92%). Univariate logistic regression did not reveal a statistically significant difference in CD-TLR with type of adjunct therapy used (p > 0.05).ConclusionIVL with adjunct use of DCB and/or atherectomy is safe and effective in treatment of calcified CFA disease. Randomized studies are required to confirm these findings. |
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