Profundoplasty in Patients with Chronic Thrombosis of the Superficial Femoral Artery Not Suitable for Distal Revascularization

The deep femoral artery is the main source of blood supply to the leg and foot when the superficial femoral artery is occluded. In this situation, the geometry of the trunk of the deep femoral artery represents a stenosis of 50 per cent interposed between the common femoral artery and the collateral circuit of the deep femoral artery. Intimal thickening of only 0,5 and 1,0 mm increases this anatomic stenosis to 64 and 76 per cent, respectively. Beyond the trunk, the cross-sectional area of the deep femoral artery circuit increases at each arterial division. Any reconstruction of the deep femoral artery intended to increase its inflow must extend down to at least it's first important bifurcation if it is to overcome this trunk "stenosis" and to carry out an anatomic bypass alone. This requirement explains the effectiveness of proper reconstruction of the deep femoral artery in avoiding or delaying amputation in patients with ischemic symptoms and occlusion of the superficial femoral artery who are not candidates for femoropopliteal reconstruction. In this case the absence of high grade stenosis is not a contraindication. The goal of our study was to evaluate the significance and the future perspectives of profundaplasty.