Treatment of common femoral artery (CFA) stenosis, either with an open or endovascular approach, is the subject of much debate, Raphaël Coscas (Paris, France) tells Vascular News at the Paris Vascular Insights (PVI) conference (23–25 November 2022, Paris, France). “Open surgery remains the gold standard,” notes Coscas, but adds however that the endovascular approach has its advantages, namely that “you will not have the local complications” that you might have with open surgery and that “the patient will be able to walk very soon after the procedure”.
Coscas goes on to outline the case of an 84-year-old male with a very calcified lesion of the distal CFA, and explains why he chose to use an endovascular approach utilising Shockwave Intravascular Lithotripsy (IVL; Shockwave Medical). Coscas explains IVL’s mechanism of action and how this differentiates from conventional percutaneous transluminal angioplasty using sonic pressure waves to crack the calcified plaque. “We use this [IVL balloon] at low pressure which is why I am not afraid to inflate the balloon in the profunda because with this four atmosphere pressure I will not damage this artery”.
The results were “really excellent,” states Coscas, adding that there was “no residual stenosis, the compliance of the vessel was modified and the patient left the hospital the same day of the procedure and was walking by himself”. Owing in large part to the therapy’s ability to modify vessel compliance, Coscas believes endovascular repair of the CFA using IVL as the main preparation tool for calcified lesions should be discussed routinely.
This video is sponsored by Shockwave Medical.
Read Raphaël Coscas’ article: Shockwave IVL: A paradigm shift in the treatment of common femoral artery lesions