Giordanengo F, Vandone P L, Mattioli A, Miani S, Giuffrida G F
Istituto di Chirurgia Generale e Cardiovascolare, Università degli Studi di Milano.
Minerva Cardioangiol. 1992 Nov;40(11):425-9.
The profunda femoris artery is the primary source of collateral flow to the lower extremity in the presence of superficial femoral and/or popliteal occlusion. The arteriosclerotic disease involvement of this segment is relatively less frequent and in the majority of the cases localized on the ostium and reaches to the first branch. Profundaplasty to relieve limb-threatening ischemia is infrequently employed as an isolated procedure. However many Authors reported their experience on this treatment, in case of critical limb ischemia in patients without significative lesions of the aortofemoral district. Our late four year experience concerns of 22 patients (18 male, 3 female). All the patients had severe ischemia of the lower limbs, with serious symptoms, such as invalidating claudicatio (13), rest pain (7) and gangrene (2). Twenty-two profundaplasty were performed as the only reconstructive procedure. There was no postoperative mortality. Two patients had above knee amputations (15 days and 14 months after the revascularization). All of the other patients improved and follow-up extended to 48 months shows a limb salvage rate of 90%. In conclusion, on the basis of our experience, we think that the operation is recommended, whenever possible, in patients with critical ischemia when the possibilities of more extensive revascularization procedures are considered to be poor.
股深动脉是在股浅动脉和/或腘动脉闭塞时下肢侧支血流的主要来源。该节段的动脉硬化疾病累及相对较少见,且在大多数情况下局限于开口处并延伸至第一分支。为缓解肢体威胁性缺血而进行的股深动脉成形术很少作为一种单独的手术使用。然而,许多作者报告了他们在治疗无主-股区明显病变的严重肢体缺血患者时的经验。我们近四年的经验涉及22例患者(18例男性,3例女性)。所有患者均有下肢严重缺血,伴有严重症状,如致残性跛行(13例)、静息痛(7例)和坏疽(2例)。22例股深动脉成形术作为唯一的重建手术进行。术后无死亡病例。2例患者在血管重建术后15天和14个月进行了膝上截肢。所有其他患者均有改善,随访至48个月显示肢体挽救率为90%。总之,根据我们的经验,我们认为,对于严重缺血且考虑更广泛血管重建手术可能性较差的患者,只要有可能,就建议进行该手术。