THE ROLE OF DEEP FEMORAL ARTERY PLASTY IN CHRONIC CRITICAL LOWER LIMB ISCHEMIA TREATMENT

In patients with chronic critical lower limb ischemia, the deep femoral artery (DFA) condition plays an important role. The localization of atherosclerotic plaque in DFA and its spread are diverse. A purposeful study of isolated profundoplasty as an independent method of revascularization of an ischemic limb belongs to P. Martin et al. (1968). According to some authors, the most important factor for predicting a satisfactory long-term result is the presence of developed collaterals from the DFA branches to the tibial arteries. At the present time, various methods of profundoplasty are performed. The most common technique for DFA reconstructing is the endarterectomy and patch angioplasty. Autogenous (autovena or autoartery) and synthetic materials may be used as a patch. In this case, profundoplasty is classified depending on the arteriotomy length: short (<2 cm), standard (<8 cm or up to the first perforator), and extended (> 8 cm, or beyond the first perforator). Profundodoplasty is a time-proven effective method of surgical intervention in the treatment of lower limb ischemia. One of the potential advantages of isolated profundoplasty may be the reduction of the ischemia degree and decrease of amputation risk. However, the question of indications for conducting profundoplasty remains unresolved. The choice of the technique and the final volume of surgical intervention is crucial for the best result (limb salvage, regression of the chronic lower limb ischemia degree).

Belov Yu.V., Stepanenko A.B., Gens A.P., Khalilov I.G. Surgical treatment of patients with multiple artery lesions of the lower extremities. Angiologiya i Sosudistaya Khirurgiya (Angiology and Vascular Surgery). 2002; 8 (1): 72-9 (in Russ.).

Burleva E.P. The value of clinical, epidemiological and economic analysis to assist patients with chronic arterial insufficiency of the lower limbs. Angiologiya i Sosudistaya Khirurgiya (Angiology and Vascular Surgery). 2002; 8 (4): 15-9 (in Russ.).

Tunis S.R., Bass E.B., Steinberg E.P. The use of angioplasty bypass surgery, and amputation in the management of peripheral vascular disease. N. Engl. J. Med. 1991; 325 (8): 556-62.

Gavrilenko A.V., Skrylev S.I. Management of patients with lower limb critical ischaemia induced by lesions of infrainguinal arteries. Angiologiya i Sosudistaya Khirurgiya (Angiology and Vascular Surgery). 2008; 14 (3): 111-7 (in Russ.).

Pokrovskiy A.V., Dan V.N., Chupin A.V., Kharazov A.F. Surgical treatment of patients with critical ischemia of the lower extremities. In: Critical ischemia. The results of the 20th century. Proceedings of the 3rd International Congress of Northern Countries and Regions. Petrozavodsk-Paris; 1999 (in Russ.).

Gavrilenko AV., Omarzhanov O.A. The choice of tactics and methods of surgical revascularization in patients with chronic lower limb ischemia on the basis of the functional reserve of microcirculation and the viability of ischemic tissue. Abstracts of the 10th All-Russian Congress of Cardiovascular Surgeons. Moscow; 2004 (in Russ.).

Knyazev M.D., Belorusov O.S. Surgery of the deep femoral artery with common atherosclerotic lesions of the aortic bifurcation and lower limb arteries. Vestnik Khirurgii imeni 1.1. Grekova (Grekov Bulletin of Surgery). 1971; 7: 61-7 (in Russ.).

Krasovskiy V.V., Chirkova V.P., Balatskiy O.A., Katsiya G.V. Different variants of critical lower limb ischemia course and treatment. Angiologiya i Sosudistaya Khirurgiya (Angiology and Vascular Surgery).1995; 3: 119-24 (in Russ.).

White C.J., Gray WA. Endovascular therapies for peripheral arterial disease: an evidence-based review. Circulation. 2007; 116 (19): 2203-15. DOI: 10.1161/CIRCULATIONAHA.106.621391

Witz M., Shnacker A., Lehmann J.M. Isolated femoral profundo-plasty using endarterectomised superficial femoral artery for limb salvage in the elderly. Minerva Cardioangiol. 2000; 48 (12): 451-4.

Graham A.M., Gewertz B.L., Zarins C.K. Efficacy of isolated pro-fundoplasty. Can. J. Surg. 1986; 29 (5): 330-2.

Sladen J.G., Burgess J.J. Profundoplasty: expectations and ominous signs. Am. J. Surg. 1980; 140 (2): 242-5. DOI: 10.1016/0002-9610(80)90015-X

Sukharev 1.1., Nikul'nikov P.I., Tupikin V.G., Zhane A.K., Polishchuk Yu.E. Deep artery of thigh and its role in reconstructive surgery of the vessels. Klinicheskaya Khirurgiya (Clinical Surgery). 1984; 7: 46-8 (in Russ.).

Dunlop G.R. In discussion of Billig D.M., Callow A.D., Deterling R.A.: Surgical considerations in the management of lesions of the profunda femoris artery. Am. J. Surg. 1970; 119: 396.

Kokhan E.P., Zavarina I.K. Selected lectures on angiology. Moscow: Nauka; 2000: 34-6 (in Russ.).

Sabaneev I.F. The question of blood vessels suture. Russkiy Khirurgicheskiy Arkhiv (Russian Surgical Archive). 1895; 4: 625-39 (in Russ.).

Morris G.C., Edwards W., Cooley DA., Crawford E.S., DeBakey M.E. Surgical importance of profound femoral artery. Arch. Surg. 1961; 82: 52-7.

Martin P., Renwick S., Stephenson C. On the surgery of the profunda femoris artery. Br. J. Surg. 1968; 55 (7): 539-42. DOI: 10.1002/bjs.1800550711

Rollins D.L., Towne J.B., Bernhard V.M., Baum P.L. Isolated pro-fundaplasty for limb salvage. J. Vasc. Surg. 1985; 2 (4): 585-90. DOI: http://dx.doi.org/10.1016/0741-5214(85)90014-X

Miksic K., Novak B. Profunda femoris revascularization in limb salvage. J. Cardiovasc. Surg. (Torino) 1986; 27 (5): 544-52.

McCoy D.M., Sawchuk A.P., Schuler J.J. et al. The role of isolated profundoplasty for the treatment of rest pain. Arch. Surg. 1989; 124: 441-4.

Brewster D.C., Perler B.A., Robinson J.G., Darling R.C. Aortofemoral graft for multilevel occlusive disease: predictors of success and need for distal bypass. Arch. Surg. 1982; 117: 1593-600.

Gavrilenko A.B., Skrylev S.I., Kuzubova E.A. Experience of surgical treatment of patients with critical ischemia of lower limbs. In: The 8th All-Russian Congress of Cardiovascular Surgeons. Moscow; 2002: 119 (in Russ.).

Mitchell R.A., Bone G.E., Bridges R., Pomajzl M.J., Fry WJ. Patient selection for isolated profundoplasty. Arteriographic correlates of operative results. Am. J. Surg. 1979; 138: 912-9.

Kazmers M., Satiani B., Evans W.E. Amputation level following unsuccessful distal limb salvage operations. Surgery. 1980; 87: 683-7.

Pokrovskiy A.V., Moskalenko Yu.D., Kiyashko V.A., Agadzhanova L. Reconstructive surgery for severe limb ischemia. Khirurgiya (Surgery). 1977; 2: 20-87 (in Russ.).

Waibel P.P. Autogenous reconstructions of the deep femoral artery. J. Cardiovasc. Surg. 1966; 7 (3): 179-81.

Feldhaus R.J., Sterpetti A.V., Schultz R.D., Peetz D.J. Jr., Albertucci M. Eversion endarterectomy of the superficial femoral artery and end-to-side anastomosis to the deep femoral artery. An alternative to extended profundoplasty. Am. J. Surg. 1985; 150 (6): 748-52. DOI: 10.1016/0002-9610(85)90422-2

Crawford E.S., Bomberger R.A., Glaeser D.H., Salwa S.A., Russell W.L. Aortoiliac occlusive disease: factors influencing survival and function folowing reconstructive operation over a twenty-five-year period. Surgery. 1981; 90 (6): 1055-67.

Pellegrino F., Boselli G. Revascularization of the deep femoral artery in the treatment of obstructive femoro-popliteal lesions. Minerva Chir. 1974; 29 (15-16): 878-84 (in Italian).

Ruberti U., Tiberio G. Use of the deep femoral artery in revascularization surgery of the lower limb. Minerva Chir. 1974; 29 (15-16): 381-9 (in Italian).

Cotton L., Roberts C., Cave F. Value of the electromagnetic flowmeter in arterial reconstruction. In: Roberts V.C. (Ed.) Blood flow measurement. London: Sector publishing; 1972: 107-10.

Boren C.H., Towne J.B., Bernhard V.M., Salles-Cunha S. Profundapopliteal collateral index: a guide to successful profun-daplasty Arch. Surg. 1980; 115 (11): 1366-72.

Kalman P.G., Hosang M., Johnston K.W., Walker P.M. The current role for femorofemoral bypass. J. Vasc. Surg. 1987; 6 (1): 71-6.

Gavrilenko AV., Kotov A.E., Loikov D.A., Alyab'ev A.S. Invention application No. 2013 154 357 “A method of treating critical limb ischemia with the calf arteries occlusion.” Inventions. Utility models. Official Bulletin of the Federal Service for Intellectual Property. 2015; 17: 20.06.2015 (in Russ.).

Pearce W.F., Kempczinski R.F. Extended autogenous profundoplas-ty and aortofemoral grafting: an alternative to synchronous distal bypass. J. Vasc. Surg. 1984; 1 (3): 455-8. DOI: 10.1016/0741-5214(84)90085-5

Ouriel K., DeWeese J.A., Ricotta J.J., Green R.M. Revascularization of the distal profunda femoris artery in the reconstructive treatment of aortoiliac occlusive disease. J. Vasc. Surg. 1987; 6 (3): 217-20.

Bernard V.M., Ray L.I., Militello J.P. The role of angioplasty of the profunda femoris artery in revascularization of the ischemic limb. Surg. Gynecol. Obstet. 1976; 142 (6): 840-4.

Dardik H., Ibrahim I.M., Jarrah M., Sussman D., Dardik I. Synchronous aortofemoral and iliofemoral bypass with revascularization of the lower extremity. Surg. Gynecol. Obstet. 1979; 149 (5): 676-80.

Malgor R.D., Ricotta J.J. 2nd, Bower T.C., Oderich G.S., Kalra M., Duncan A.A., Gloviczki P Common femoral artery endarterectomy for lower-extremity ischemia: evaluating the need for additional distal limb revascularization. Ann. Vasc. Surg. 2012; 26 (7): 946-56. DOI: 10.1016/j.avsg.2012.02.014

Heyden B., Vollmar J., Voss E.U. Principles of operations for combined aortoiliac and femoropopliteal occlusive lesions. Surg. Gynecol. Obstet. 1980; 151 (4): 519-24.

Prendiville E.J., Burke P.E., Colgan M.P., Wee B.L., Moore D.J., Shanik D.G. The profunda femoris: a durable outflow vessel in aortofemoral surgery. J. Vasc. Surg. 1992; 16 (1): 23-9.