Superficial femoral-profunda femoris artery transposition

Generally, either reconstruction of or bypassing the femoropopliteal artery is used in lower-limb ischemia. During the last three years, five patients with advanced aortoiliac atherosclerotic occlusive disease, occlusion of the superficial femoral arteries, and multiple stenotic lesions of the profunda femoris artery underwent aortofemoral bypass, superficial femoral artery eversion endarterectomy, and superficial femoral-profunda femoris artery transposition. Three patients have been followed up to four years with patent grafts. One patient died in the immediate postoperative period of a cerebrovascular accident and another required amputation because of persistent ischemic changes and severe "distal" vessel disease. Revascularization of the profunda is necessary when there is concurrent superficial femoral artery occlusion and stenotic lesions of the profunda femoris artery. Transposition of an endarterectomized superficial femoral artery to distal undiseased profunda femoris artery affords on alternative revascularization procedure in the multisegmental diseased profunda where a long segmental endarterectomy of the profunda femoris artery would be hazardous.