Immediate and late results of aortofemoral bypass grafting with blood flow initiation through the deep femoral artery

Introduction . The variability of the anatomical structure of the deep femoral artery is well known and described in many publications by Russian and foreign authors. Being a vessel with an extensive collateral ways, it becomes an excellent reservoir in case of bypass interventions on the aorto-femoral segment, and sometimes is an in-flow artery during reconstruction of the femoro-popliteal segment. Despite its good study, the question of the effectiveness of surgical interventions performed with a launch on the deep femoral artery with its magistral or scattered type of structure remains open. The objective was to evaluate the results of open surgery – aorto-femoral bypass, with a launch on the deep femoral artery, taking into account the type of its anatomical structure. Methods and materials. An analysis of the results of surgical treatment of 63 patients with the aorto-femoral segment occlusion, corresponding to type D, according to the TASC II classification, was carried out. All patients were divided into 2 groups depending on the type of structure of the deep femoral artery: I – magistral type; II – scattered type. The analysis included the results of the immediate and remote patency of the structure, the effectiveness of the interventions performed, patient survival, as well as the presence of factors that can directly or indirectly affect the course of the postoperative period. Results. The immediate results of the interventions performed showed their effectiveness, manifested by an increase in the distance of pain-free walking, relief of pain, healing of trophic ulcers, regardless of the type of structure of the deep femoral artery (p<0.001). Five years after the operation, a greater number of thromboses of the aorto-femoral bypass graft was noted with a scattered type of artery structure (p=0.03). Factors that increase the risk of thrombosis in the late postoperative period were the scattered type of structure of the deep femoral artery and atrial fibrillation (p=0.04). Conclusion. Aorto-femoral bypass grafting with initiation to the deep femoral artery is an effective treatment method regardless of the type of structure of the deep femoral artery, but late results show a significant advantage of the magistral type in terms of patency of the structure and maintaining quality of life.