RECONSTRUCTION OF DEEP FEMORAL ARTERY FOR CHRONIC ISCHEMIA OF LOWER EXTREMITIES

S.A. Dadvani, K.B. Frolov, E.G. Artyukhina, V.E. Sinitsyn, E.A. Timonina

From 1994 till January 1999 in the Department of Vascular Surgery, Faculty Surgical Clinics, l.M. Sechenov Moscow Medical Academy 165 patients underwent aortofemoral reconstruction for arteriosclerosis obliterans. Isolated atherosclerotic lesions of aorta and iliac arteries were seldom, most of patients (83.5%) demonstrated additional lesions. In 69% of cases deep femoral artery (DFA) was the main route of revasculariwtion. Rheovasography, Doppler ultrasonography (DUS) with measurement of segmental AP, dupplex scanning with color flow mapping (DS with CFM), contrastenhanced aortoarteriography (CEAAG), computer tomography (CT) and magnetic resonance angiography (MRA) were carried out preoperatively. DS appeared to be highly sensitive for assessment of DFA (98%), thus this modality became the main diagnostic tool for surgical decision making. A correlation between deep femoropopliteal collateral index (DFPCI) and successful outcome was shown. Aortofemoral reconstructions were fulfilled in 114 patients: aortofemoral bypass – in 95, grafting – in 11, endarterectomy from iliac arteries – in 8 patients. DFA reconstruction as a sole procedure was carried out in 51 patients: transfemoral profundoplasty – in 31, Martin 's expanded trunk arterioplasty – in 11, Weibel's procedure – in 9. Significant clinical improvement after limb revascularization through DFA system was documented in 81% of patients. DFA revascularizafion meeting strict indications enables to achieve good clinical results and avoid invasive surgical interventions.

KEY WORDS: profundoplasty, diagnosis of deep femoral artery lesions, lower limb ischemia.

P. 66-73

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