Revascularization of the profunda femoris artery in aortoiliac occlusive disease.

We have presented both early and late results in 236 extremities revascularized by aortofemoral, axillofemoral, or femorofemoral bypass grafts for severe atherosclerotic disease. The superficial femoral artery was occluded in all patients and initial outflow was provided solely through the profunda femoris system. Five different categories have been defined based on the procedure utilized to insure patency of the proximal profunda system. Subsequent patency rates are determined for each category. In reviewing our total experience the profunda femoris system was adequate to maintain both graft patency and limb viability in 90.3 percent of extremities in the early postoperative period. This declined to 78.5 percent at 5 year follow-up. Femoropopliteal bypass was required in 16 patients within the first postoperative month to maintain graft patency or relieve persistent ischemia. It is suggested that the addition of femoropopliteal bypass may improve inmediate and long-term patency rates and offer greater assurance that ischemia will be relieved.