Recently, some authors report than profunda femoris artery may play a role, as a substitute for the role of superficial femoral artery that supplies blood to lower extremity. For th purpose fo reduction f the number of subsequent distal bypass
surgery
and aid for improvement of limb salvage rate many authors employ the method of profundoplasty in their armamentarium and report favorable results.
For evaluation of the efficacy of profundoplasty, the results of aortoiliac bypass graft with profundoplasty were retrospectively analyzed in 18 pateitns that were operated upon their aor toiliac occlusion with superficial femoral artry
occlusion,
in
the Korea University Hospital, between the period from 1988 to 1991.
The results were as follows; Among 18 patients, there were 16 males and 2 females. In 12 patients, femoropopliteal occlusion was visualized aortoiliac occlusion on their angiographic findings in preoperative period. But, in 6 patients,
femoro-popliteal
occlusion was not visualized prior to oepration, and they were found during operation. In 6 patients occlusion site was found on right side and in 8 patients occlusion site was on left side. occlusions on both sides were noted in 4 patients.
After
immediate postoeprative period, 11 marked improvement of claudication and 2 moderate improvement were observed in 13 patients with claudication prior to oepration. 2 resting pain patients were obvserved in marked improvement of symptom in all
cases
Among the 3 patients with gangrene 1 patients healed after operation, and subsequent femoropopliteal bypass was performed in 1 of 2 patients with persistence of foot gangrene. Considering the long term patency rate, during follow up period of 2
years to
5 years after operation, occlusion of bypass was occured in 2 cases.
In summary, for combined aortoiliac and superficial femoral arterial occlusive lesions with poor distal run-off, profundoplasty can be an initial procedure. Femoro-popliteal bypass is performed for patients with failed profundoplasty.
|