Revascularization of the distal profunda femoris artery in the reconstructive treatment of aortoiliac occlusive disease.

The distal profunda femoris artery is frequently spared from atherosclerosis and can be used as a recipient vessel in the absence of a satisfactory common or superficial femoral artery. During a 15-year period 53 inflow procedures were done to the distal profunda femoris artery at a point more than 3 cm from its origin. The ankle-brachial systolic pressure index increased an average of 0.27 +/- 0.04 postoperatively. Limb salvage was achieved in 33 of 37 threatened extremities (89%) and claudication improved in 10 of 14 cases (71%). Symptomatic improvement was dependent on an open popliteal segment and a low profundapopliteal collateral index. The overall 4-year patency by life-table methods was 76%, with a patency of 100% for femoroprofunda crossover grafts, 96% for aorto- and ilioprofunda grafts but only 26% for axilloprofunda grafts. Bypass to the distal profunda femoris artery represents a viable alternative when the common and superficial femoral arteries are unsuitable for outflow, with results comparable to procedures done to a healthy common femoral artery.