Özdemir-van Brunschot Denise Michelle Danielle, Holzhey David
Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany.
Department of Vascular Surgery and Endovascular Therapy, Augusta Hospital and Catholic Hospital Group, 40472 Düsseldorf, Germany.
J Clin Med. 2025 Aug 22;14(17):5938. doi: 10.3390/jcm14175938.
: To date, it remains unclear which patients with occluded superficial femoral arteries (SFA) benefit from profundoplasty. Our hypothesis is that certain anatomic factors regarding the femoral bifurcation, e.g., the degree of stenosis of the common or deep femoral artery (CFA or DFA), length of stenosis of the DFA, or number of collaterals, can predict clinical success. : An analysis pilot study was conducted to determine if the aforementioned anatomical features can predict clinical improvement and the need for major amputation following profundoplasty in patients with an occluded SFA. : Forty-nine patients were included in the analysis, most of whom were male (67.3%). The median stenosis of the CFA was 70%, and the mean stenosis of the DFA was 61%. During the follow-up period (mean 14.7 months), six major amputations were performed and 10 femoropopliteal or -crural bypasses were performed. The degree of DFA stenosis was a protective factor for major amputation ( 0.04). The degree of DFA stenosis and the runoff score were associated with improvement of the Rutherford classification. However, in the multivariate analyses, none of the parameters were associated with the risk of amputation, need for peripheral bypass, or clinical improvement. : Although this is a small and retrospective study, it suggests that a higher degree of DFA stenosis may be associated with a greater benefit from profundoplasty and a lower risk of major amputation. Further validation with larger patient populations and longer follow-up periods are necessary.
迄今为止，仍不清楚哪些股浅动脉（SFA）闭塞患者能从股深动脉成形术中获益。我们的假设是，一些与股动脉分叉相关的解剖学因素，例如股总动脉或股深动脉（CFA或DFA）的狭窄程度、DFA的狭窄长度或侧支数量，可以预测临床成功率。
开展了一项分析性初步研究，以确定上述解剖学特征能否预测SFA闭塞患者行股深动脉成形术后的临床改善情况以及大截肢的必要性。
49例患者纳入分析，其中大多数为男性（67.3%）。CFA的中位狭窄率为70%，DFA的平均狭窄率为61%。在随访期（平均14.7个月）内，实施了6例大截肢手术，10例股腘或股胫旁路移植术。DFA狭窄程度是大截肢的保护因素（P = 0.04）。DFA狭窄程度和血流灌注评分与卢瑟福分级的改善相关。然而，在多变量分析中，没有一个参数与截肢风险、外周旁路移植术的必要性或临床改善相关。
尽管这是一项小型回顾性研究，但提示DFA较高的狭窄程度可能与股深动脉成形术更大的获益和更低的大截肢风险相关。需要更大的患者群体和更长的随访期进行进一步验证。
