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ORIGINAL ARTICLES
NUMBER 4 YEAR 2007
The Profunda Femoris Artery - A Pertinent Alternative for Revascularisation of the Patients with Atherosclerotic Occlusive Disease of the Lower Extremity with Multilevel Lesions
1 Vascular Surgery Department, Clinical Emergency County Hospital Timisoara,
2 1st General Surgery Department, Clinical Emergency Municipal Hospital Timisoara,
3 1st Cardiovascular Surgery Department, Institute of Cardiovascular Medicine Timisoara

Correspondence to:
Georgel Taranu, Vascular Surgery Department, Clinical Emergency County Hospital, 10, Dr. I. Bulbuca Bld., 300736 Timisoara, Tel. +40-748331475
Email: gptgeorgel@yahoo.com
REZUMAT
Introducere: Artera femurala profunda reprezinta una dintre alternativele de run-off frecvent utilizate in cadrul revascularizarii pacientilor care prezinta leziuni multiple etajate, localizate atit in sfera aorto-iliaca, cit si in etajul infrainghinal (sindromul Leriche tip III). Fata de revascularizarea secventiala, limitata in prima etapa la artera femurala profunda, se ridica optiunea revascularizarii complete per primam. in favoarea revascularizarii pe artera femurala profunda se aduc mai multe argumente si contraargumente, dar principala problema care se ridica este data de patenta pe termen mediu si lung a reconstructiei arteriale. La ora actuala literatura de specialitate nu precizeaza cu claritate criteriile care trebuie sa faca diferenta intre grupul de pacienti care vor beneficia de revascularizarea pe femurala profunda si pacientii care au din start indicatie de revascularizare completa. Material si metode: Studiul isi propune sa analizeze rezultatele obtinute in urma a 20 de cazuri revascularizate doar pe artera femurala profunda. Dintre cele 20 de cazuri, 17 au fost revascularizari programate, iar 3 au fost cazuri operate in urgenta. Urmarirea postoperatorie s-a efectuat pe un interval cuprins intre 3 si 15 luni, cu o medie de 12 luni. Rezultate: Patenta primara la 30 de zile a fost de 96%, iar la 12 luni de 92%, iar patenta secundara a fost de 96% la o luna, respectiv la 12 luni. Au fost efectuate doua amputatii de coapsa, dintre care una singura pentru tromboza reconstructiei (una a fost efectuata pentru sepsa severa de gamba dupa fasciotomii), cu o rata de salvare a membrului inferior de 92% la o luna, respectiv la 12 luni. Concluzii: Rezultatele obtinute pledeaza pentru abordul secvential al leziunilor multiple in conditiile in care artera femurala profunda ofera un run-off de calitate, dar sunt necesare date suplimentare pentru validarea statistica a acestor rezultate.

ABSTRACT
Introduction: The profunda femoral artery (PFA) represents one of the most frequently used runoff alternatives for the revascularization of the patients with multilevel lesions, localized both in the aortoiliac and infrainguinal segment (Leriche syndrome type III). Toward of the sequential revascularization, limited in the first step to the profunda femoral artery, it raises the option of complete revascularization. Favorable to the profunda femoral revascularization we bring more reasons and cons, but the main problem remains the mid- and long-term patency of the reconstruction. At this time the specialty literature doesn't clearly specify the criteria for surgical indication between the patients with revascularization limited on the PFA and the patients with complete revascularization. Material and methods: The study is analyzing the results obtained in 20 cases of revascularization using PFA. Among these 20 cases, 17 of them were programmed revascularizations and 3 were emergency cases. The postoperative follow-up was between 3 and 15 months, with a mean follow-up of 12 months. Results: The primary patency after 30 days was 96% and 92% at 12 month. The secondary patency was 96 % after one month respectively 12 month. Two amputations were effectuated, one for the thrombosis of the reconstruction and one for severe calf sepsis following fasciotomy, with an overall limb salvage rate of 92%. Conclusion: The results advocate the sequential approach of multilevel atherosclerotique peripheral disease, but only with a good quality PFA as a run-off vessel. There are still necessary supplementary data for statistically validation of these results.


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