Abstract
The deep femoral artery (DFA) and superficial femoral artery (SFA) are the main outflow tracks used in reconstruction of the aortoiliac segment. The DFA can be used as an alternative source of inflow in arterial reconstruction in the lower limbs, particularly in reoperative procedures (Brewster et al. 1987; DePalma et al. 1980). Many patients who have ischemia that is severe enough to require bypass also have occlusion of the SFA. This occlusion usually begins at the adductor canal and may proceed up to the origin of the SFA. As a result, the SFA is the functional outflow even when the graft is attached to the common femoral artery (CFA). Therefore, the surgeon must visualize the orifice of the DFA at operation. When performing aortofemoral bypass for limb salvage, we often put a tongue of the distal aortofemoral bypass graft down onto the DFA. A DFA free of disease beyond the first centimeter will usually support an aortofemoral, axillary-to- femoral, or femoral-to-femoral graft even when the superficial femoral artery is entirely occluded. The distal end of the DFA has rich collaterals around the knee via the genicular arteries (see Fig. 6 in Chap. 1). In patients whose aortofemoral bypass has failed, the DFA is often the artery of choice to provide outflow. This chapter is limited to a discussion of reconstruction by grafting and endarterectomy of the DFA.
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References
Bandyk DF (1990) Postoperative surveillance of infrainguinal bypass. Surg Clin North Am 70: 71–85
Boren CH, Towne JB, Bernhard VM, Salles-Cunha S (1980) Profundapopliteal collateral index: a guide to successful profundaplasty. Arch Surg 115: 1366–1372
Brewster DC (1989) Direct reconstruction for aortoiliac occlusive disease. In: Rutherford RB (ed) Vascular surgery, 3rd edn. Saunders, Philadelphia, pp 667–691
Brewster DC, Meier GH III, Darling RC, Moncure AC, LaMuraglia GM, Abbott WM (1987) Reoperation for aortofemoral graft limb occlusion: optimal methods and long term results. J Vase Surg 5: 363–374
Brief DK, Brener BJ, Alpert J, Parsonnet V (1975) Crossover femorofemoral grafts followed up five years or more: an analysis. Arch Surg 110: 1294–1299
DePalma RG, Malgieri JJ, Rhodes RS, Clowes AW (1980) Profunda femoris bypass for secondary revascularization. Surg Gynecol Obstet 151: 387–390
Flinn WR, Yao JST, Bergan JJ (1982) Aneurysms of secondary and tertiary branches of major arteries. In: Began JJ, Yao JST (eds) Aneurysms: diagnosis and treatment. Grune and Stratton, New York, pp 449–467
Freischlag JA, Moore WS (1989) Infection in prosthetic grafts. In: Rutherford RB (ed) Vascular surgery, 3rd edn. Saunders, Philadelphia, pp 510–521
King TA, DePalma RG, Rhodes RS (1984) Diabetes mellitus and atherosclerotic involvement of the profunda femoris artery. Surg Gynecol Obstet 159: 553–556
Martin RS III (1984) Thigh claudication due to profunda femoris artery occlusion. J Vase Surg 1: 692–694
Miksic K, Novak B (1986) Profunda femoris revascularization in limb salvage. J Cardiovasc Surg 27: 544–552
Nunez AA, Veith FJ, Collier P, Ascer A, White Flores S, Gupta SK (1988) Direct approaches to the distal portions of the deep femoral artery for limb salvage bypasses. J Vase Surg 8: 576–581
Ouriel K, DeWeese JA, Ricotta JJ, Green RM (1987) Revascularization of the distal profunda femoris artery in the reconstructive treatment of aortoiliac occlusive disease. J Vase Surg 6: 217–220
Persson AV (1984) Extra-anatomic bypass for lower extremity revascularization. In: Rutherford RB (ed) Vascular surgery, 2nd edn. Saunders, Philadelphia, pp 523–526
Persson AV, Dyer VE, West LS (1980) Femoral-to-femoral bypass graft. Surg Clin North Am 60: 537–544
Rapoport S, Sniderman KW, Morse SS, Proto MH, Ross GR (1985) Pseudo- aneurysm: a complication of faulty technique in femoral arterial puncture. Radiology 154: 529–530
Rollins DL, Towne JB, Bernhard VM, Baum PL (1985a) Endarterectomized superficial femoral artery as an arterial patch. Arch Surg 120: 367–369
Rollins DL, Towne JB, Bernhard VM, Baum PL (1985b) Isolated profundaplasty for limb salvage. J Vase Surg 2: 585–590
Rutherford RB, Bauer AE (1989) Extra-anatomic bypass. In Rutherford RB (ed) Vascular surgery, 3rd edn. Saunders, Philadelphia, pp 705–716
Simma W, Bassiouny H, Hartl P, Brcke P (1986) Evaluation of profundoplasty in reconstructions of combined aorto-iliac and femoro-popliteal occlusive disease. J Cardiovasc Surg 27: 141–145
Sproul G 1968 ) Reconstruction of the profunda femoris artery. Surgery 63: 871 – 874
Towne JB, Bernhard VM, Rollins DL, Baum PL (1981) Profundaplasty in per-spective: limitations in the long-term management of limb ischemia. Surgery 90: 1037–1046
Welsh P, Repetto R (1975) Revascularization of the profunda femoris artery in aortoiliac occlusive disease. Surgery 78: 389–393
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© 1994 Springer-Verlag Berlin Heidelberg
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Persson, A.V., Lange, B. (1994). Deep Femoral Artery Reconstruction. In: Surgery of the Deep Femoral Artery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-79045-4_10
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DOI: https://doi.org/10.1007/978-3-642-79045-4_10
Publisher Name: Springer, Berlin, Heidelberg
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