The specificities of the common femoral artery anatomy, calcification and endovascular treatment.

Atherosclerotic lesions of the femoral artery bifurcation are one of the most complex lesion subsets commonly encountered in peripheral artery disease. Common femoral endarterectomy remains the standard of care in this location due to the bulky, eccentric, heavily calcified nature of the plaques, the frequent involvement of the femoral bifurcation, and the risk of compromising future femoral approaches. Recent studies have reported high rates of technical success and low rates of complications with endovascular treatment of the femoral artery bifurcation. This is related to improvements of endovascular equipment and the technical skills of operators. The aim of this manuscript was to provide a comprehensive review of the peculiarities of common femoral artery anatomy, calcification and treatment.

Combined Pull through and Balloon Anchoring Bailout Technique to Repair a Failed Bifurcated Endovascular Aortic Repair.

BACKGROUND: To describe a bailout technique used to manage the left stump of a bifurcated endograft that was stuck above a narrowed distal aortic neck. METHODS: An 80-year-old man with a suprarenal aneurysm was treated with a custom-made 4-vessel fenestration endograft. During the procedure, the left stump of the distal bifurcated graft module was chased out of a narrow distal aortic neck and became stuck horizontally at the bottom of the aortic aneurysmal sac. Through a femoral to left subclavian artery through-and-through percutaneous access, a balloon-anchoring technique was successfully used to return the endograft stump into the narrowed aortic neck and exclude the aneurysm. CONCLUSIONS: The combined technique of a through-and-through and anchoring balloon was found to be suitable for introducing an endograft limb into a narrow distal aortic neck.