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Biomedicines
Volume 13
Issue 12
10.3390/biomedicines13123075
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Mid- and Long-Term Results of Covered Stents for Iatrogenic Common Femoral Artery Injury

by
Francesca Miceli
1,
Giulia Demirxhiu
1,
Alessia Di Girolamo
1,
Antonio Marzano
1,
Andrea Molinari
1,
Rocco Cangiano
1,
Marta Ascione
1,
Francesco Ajmone
2,
Gennaro Sardella
2,
Massimo Mancone
2,
Luca di Marzo
1 and
Wassim Mansour
1,*
1
Vascular and Endovascular Surgery Division, Department of General Surgery, Specialties and Anaestesiology, Policlinico Umberto I, “Sapienza” University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
2
Cardiac Surgery Division, Department of Cardio-Thoraco-Vascular Surgery, Policlinico Umberto I, “Sapienza” University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
*
Author to whom correspondence should be addressed.
Biomedicines 2025, 13(12), 3075; https://doi.org/10.3390/biomedicines13123075 (registering DOI)
Submission received: 21 October 2025 / Revised: 4 December 2025 / Accepted: 11 December 2025 / Published: 12 December 2025
(This article belongs to the Section Molecular and Translational Medicine)
Versions Notes

Abstract

Background/Objectives: The increasing use of endovascular procedures with common femoral artery (CFA) access has led to a rise in iatrogenic arterial injuries at this site. The most frequent injuries are pseudoaneurysms (PSA), retrograde dissections (RD), arteriovenous fistulas (AVF), and arterial perforations. Surgical repair is the standard treatment; however, the use of covered stents (CS) may represent a valid alternative, despite current instructions for use (IFU) not recommending CFA implantation. Methods: We conducted a single-center retrospective study on a prospectively maintained database. Patients undergoing transcatheter aortic valve repair (TAVR), endovascular aortic repair EVAR, diagnostic or therapeutic coronary angiography, or peripheral percutaneous transluminal angioplasty, who were subsequently treated for CFA injury with CS implantation between February 2015 and May 2024, were included. Endpoints were technical success (complete arterial repair), 30-day mortality, overall mortality, reintervention rates, and long-term stent patency. Results: A total of 41 patients were included: 10 (24.4%) PSA, 3 (7.3%) AVF, 27 (65.8%) perforations, and 2 (4.9%) RD. Of which 28 (68.3%) were treated with self-expandable CS and 13 (31.7%) with balloon-expandable CS. Additionally, 33 (80.5%) underwent urgent treatment. Technical success was achieved in 97.5%. Thirty-day mortality was 7.3%, with no procedure-related deaths. At a mean follow-up of 50.8 months (range 1–109), survival was 63.4%, with 100% stent patency and no procedure-related reinterventions. Conclusions: CS implantation for CFA iatrogenic injuries achieved high technical success and excellent long-term patency, representing a viable alternative to open repair. Further studies are needed to integrate CS use for CFA injuries into treatment algorithms and to update device IFUs accordingly.
Keywords: peripheral artery injury; covered-stent; vascular trauma; access-site complications; pseudoaneurysm; retrograde dissection; arterial perforation; arteriovenous fistula peripheral artery injury; covered-stent; vascular trauma; access-site complications; pseudoaneurysm; retrograde dissection; arterial perforation; arteriovenous fistula

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MDPI and ACS Style

Miceli, F.; Demirxhiu, G.; Di Girolamo, A.; Marzano, A.; Molinari, A.; Cangiano, R.; Ascione, M.; Ajmone, F.; Sardella, G.; Mancone, M.; et al. Mid- and Long-Term Results of Covered Stents for Iatrogenic Common Femoral Artery Injury. Biomedicines 2025, 13, 3075. https://doi.org/10.3390/biomedicines13123075

AMA Style

Miceli F, Demirxhiu G, Di Girolamo A, Marzano A, Molinari A, Cangiano R, Ascione M, Ajmone F, Sardella G, Mancone M, et al. Mid- and Long-Term Results of Covered Stents for Iatrogenic Common Femoral Artery Injury. Biomedicines. 2025; 13(12):3075. https://doi.org/10.3390/biomedicines13123075

Chicago/Turabian Style

Miceli, Francesca, Giulia Demirxhiu, Alessia Di Girolamo, Antonio Marzano, Andrea Molinari, Rocco Cangiano, Marta Ascione, Francesco Ajmone, Gennaro Sardella, Massimo Mancone, and et al. 2025. "Mid- and Long-Term Results of Covered Stents for Iatrogenic Common Femoral Artery Injury" Biomedicines 13, no. 12: 3075. https://doi.org/10.3390/biomedicines13123075

APA Style

Miceli, F., Demirxhiu, G., Di Girolamo, A., Marzano, A., Molinari, A., Cangiano, R., Ascione, M., Ajmone, F., Sardella, G., Mancone, M., Marzo, L. d., & Mansour, W. (2025). Mid- and Long-Term Results of Covered Stents for Iatrogenic Common Femoral Artery Injury. Biomedicines, 13(12), 3075. https://doi.org/10.3390/biomedicines13123075

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