Aortobifemoral bypass in the presence of superficial femoral artery occlusion: does the profunda femoris artery provide adequate runoff?

Of a total of 492 patients (984 limbs) undergoing aortobifemoral bypass for aorto-iliac disease, 123 limbs with occlusion of the superficial femoral artery (SFA) were compared with 861 limbs with a patent SFA, and were prospectively monitored to assess the efficacy of the profunda femoris artery (PFA) as sole 'runoff' of this operation. There were more late occlusions in the limbs with occluded SFA (15%) compared to those with a patent SFA to begin with (7%). The five-year patency rate was 87% for limbs with patent SFA and 80% for limbs with occluded SFA. Claudicants had a higher 5-year patency rate compared to threatened limbs irrespective of runoff. We conclude that profunda femoris can be used as sole runoff although the rate of occlusion tends to be higher in this group compared with counterparts with patent SFA.