Long-Term Limb Complications of Common Femoral Artery Stents
Jung H. Yun, BS, Christopher Riis, BS, Richard K. Schwartz, DO, Khaled Salhab, MD, George L. Hines, MD.
NYU Winthrop Hospital, Mineola, NY, USA.
OBJECTIVES – The objective of this study is to evaluate the incidence of limb complications in patients who had stents placed in the common femoral artery.
METHODS – This is a retrospective database analysis of common femoral artery stents placed during transfemoral aortic valve replacement (TAVR) for either localized dissection or bleeding after deployment of closure devices from 2012-2018. Standard demographics and comorbidities including external iliac diameter, indication for stenting, and type of stent (covered or bare metal) were evaluated. Patients who required emergent operative intervention for vascular complications during the index procedure were excluded. Patients were contacted to determine possible development of ipsilateral limb complication – decrease in walking ability, rest pain, and limb-threatening ischemia. Fisher’s exact test was performed to evaluate correlation of risk factors with complications.
RESULTS – 84 patients (34 males, 50 females) had femoral artery stents. 21 patients died during follow-up and 3 patients were lost to follow-up. The follow-up data was available in 61 patients. The indication for stenting was bleeding in 71 patients (87%) and dissection in 10 patients (12%). BMS was employed in 14 patients (17%), Viabahn stents in 24 patients (30%), and iCAST stents in 43 patients (53%). 2 out of 23 males (8.7%) and 6 out of 39 females (15.4%) developed ipsilateral claudication. No patients developed limb-threatening ischemia or underwent amputation. Statistical analysis showed no statistically significant difference between development of symptoms and comorbidities, indication for stenting, type of stent, or external iliac diameter.
CONCLUSIONS – This study indicated no correlation between risk factors or comorbidities and development of limb complications. None of the TAVR patients developed limb-threatening ischemia or required intervention to address increasing symptoms. Limitations to the study include small sample size and insufficient follow-up studies that include hemodynamic or duplex evaluations of the lower extremity and common femoral artery stents.
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