title: The role of the deep femoral artery in the treatment of thigh claudication in case of hypogastric occlusion.
abstract: BACKGROUND
  This study evaluated the clinical and functional efficiency of deep femoral artery (DFA) revascularization in treating thigh claudication associated with ipsilateral internal iliac artery (IIA) occlusion.
  
  
  METHODS
  The files of patients presenting with proximal claudication, ipsilateral IIA occlusion, and conventional surgical revascularization of DFA were retrospectively reviewed. Each patient benefited from preoperative and postoperative measurement of dynamic transcutaneous pressure of oxygen (TcPO2) and presented with preoperative proximal stress-related ischemia and with the clinical symptoms of buttock, thigh, or groin pain.
  
  
  RESULTS
  Between May 2001 and December 2009, 23 DFA revascularizations were performed on 19 patients. Proximal stress-related pain disappeared in 17 lower limbs (74%). No postoperative thromboses were noted. Mean maximum walking distance (MWD) significantly improved (149±113 vs. 414±257 m; P<0.025), as did the ankle to arm systolic pressure index (0.71±0.17 vs. 0.90±0.19; P<0.005). Disappearance of proximal stress ischemia, revealed through postoperative dynamic TcPO2, measurement, occurred in 6 lower limbs (26%). Patency of ipsilateral superficial femoral artery, ipsilateral to the symptoms, seemed to be a predictive factor of MWD improvement (P<0.05).
  
  
  CONCLUSIONS
  DFA revascularization is an efficient treatment for thigh claudication in case of IIA occlusion, even if the results are less satisfactory than those obtained through direct revascularizations of this artery.
authors: Vascular and Thoracic Surgery Department, University Hospital, Angers, France. JePicquet@chu-angers.fr
authors: Jean
authors: J
authors: Picquet
authors: Antoine
authors: A
authors: Paumier
authors: Estelle
authors: E
authors: Maugin
authors: Xavier
authors: X
authors: Papon
authors: Bernard
authors: B
authors: Enon
authors: Pierre
authors: P
authors: Abraham
mesh_terms: D000792:Angiography; D001157:Arterial Occlusive Diseases / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D005080:Exercise Test; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007083:Iliac Artery; D007383:Intermittent Claudication / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013848:Thigh / Q000098:blood supply*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*