Revascularization for the Patients with Common Femoral Artery Occlusive Lesion

Endovascular treatment (EVT) is now performed worldwide for patients with lower extremity artery disease due to its safety and advances in devices. However, a common femoral artery (CFA) lesion often has severe calcification, and balloon angioplasty alone for such a lesion is ineffective in terms of patency. EVT with stent implantation for a CFA lesion may result in stent fracture and difficulty with puncture for subsequent interventions during the follow-up period. Given these issues, endarterectomy for a CFA lesion remains as the gold standard treatment in the endovascular era. However, the method of endarterectomy (i.e., arterial incision, patch use or not, patch material, intimal layer fixation or not) differs among centers. Thus, further investigation is needed for each method to promote the performance of high-quality CFA endarterectomy by vascular surgeons in the current endovascular era. (This is a translation of Jpn J Vasc Surg 2024; 33: 91–95.)