USE OF THE DEEP FEMORAL-ARTERY FOR ANASTO MOSIS IN PROXIMAL AND DISTAL BYPASSES - INDICATIONS, TECHNIQUE, OUTCOME OF 19 CASES

Atherosclerosis predominantly affects the ilio-superficial femoral axi s, and tends to spare the deep femoral artery which can offer excellen t outflow for proximal reconstructions for occlusive vascular disease of the lower limbs. Often symptoms are relieved and ischemic lesions c an heal. The deep femoral artery can also provide good, pulsatile infl ow for distal reconstructions when it is desirable to avoid the groin (either because of multiple previous dissections or because of infecti on). Occasionally two-level sequential bypasses to and from the deep f emoral artery are required for multilevel disease where the groin is t o be avoided. Over the past 4 years we have performed 190 arterial rec onstructions (41 central, 125 distal and 24 sequential two-level proce dures). 19 times the proximal, distal or intermediate anastomosis was on the deep femoral artery. Short- and long-term results were good in these difficult patients, with relief of symptoms or significant impro vement in most patients. Two major (and no minor) amputations were ult imately required. Arterial reconstructions using the deep femoral arte ry cannot only salvage many limbs, but offer good symptomatic relief i n patients who are not suitable for usual reconstructive procedures.