Conservative management of acute thrombosis in the superficial femoral artery.

The management of acute occlusion of the superficial femoral artery due to thrombosis is controversial. Each of nine patients with this condition whom we treated conservatively improved clinically, apparently without any change in the perfusion of the limb. We feel the results are not primarily due to a hemodynamic improvement by means of increased formation of collateral vessels but are due to the fact that physical training and ischemia enable skeletal muscle to adapt to hypoxia by increasing its oxidative capacity and altering its substrate preference. Therefore, an initially conservative approach to acute superficial femoral artery thrombosis is justified if the limb is viable.