BACKGROUND: Deep femoral artery can be the most distal technical option as donor site in patients with critical limb ischemia presenting superficial artery occlusion and hostile groins. OBJECTIVE: To retrospectively assess the deep femoral artery as an inflow site for infragenicular bypass grafts. METHODS: From 2000 to 2005, 129 infragenicular bypass grafts with proximal anastomosis located in femoral arteries were performed. Forty were located in the common femoral artery (CFA), 72 in the superficial femoral artery (SFA) and 17 in the deep femoral artery (DFA). Indications for using the DFA as inflow were hostile groin (six cases), limited arterial substitute length (six cases) or both (five cases). Anastomosis site was located in the first or second portion in 12 cases, and in the third in five cases. The surgery was secondary in 47% of the cases, and the arterial substitutes used were arm veins (11), greater saphenous vein (five) and lesser saphenous vein (one). RESULTS: Primary patency and limb salvage rates were 68.0 and 84.7%, respectively, with acceptable standard error (0.1) in 36 months. The results of patency divided by inflow artery were similar (CFA, 63.3%; SFA, 70.2%; DFA 64.7%; p = 0.63), as well as limb salvage rates (CFA, 83.1%; SFA, 82.4%; DFA 92.3%; p = 0.78). Analyzing the deep femoral group, no difference of patency rates was observed when the anastomotic site was compared (proximal vs. distal portions of the DFA) or between patients with or without previous grafts. (p = 0.89 and 0.77, respectively). CONCLUSION: Deep femoral artery is a feasible and effective option as donor site for infragenicular bypass grafts, with satisfactory patency and limb salvage rates.
Deep femoral artery; proximal anastomosis; infragenicular bypass grafts
