Percutaneous transluminal angioplasty (PTA) of the deep femoral artery (DFA) was performed in 21 patients with chronically occluded superficial femoral artery (SFA) and a significant DFA lesion as documented by arteriography. The authors failed to pass the guidewire through the occlusion in two patients. The results do not include another patient who, while the PTA was technically successful, had to have a limb amputated because of skin lesion infection. The remaining 18 patients showed a significant increase in the ankle-arm pressure index, prolongation of the claudication interval and reported subjective improvement immediately after PTA; plethysmography performed in 14 patients revealed a significant increase in maximum foot blood flow. While the claudication intervals were found to have further significantly prolonged 6-12 months following PTA, the ankle-arm pressure index remained unchanged. There were no serious complications during and after the PTA procedure. In patients with both superficial and deep femoral artery involvement, where SFA PTA is not suitable or feasible, PTA of the DFA seems to be the method of choice. Considering its probable clinical benefits, it is appropriate to attempt it even in cases where the chances of technical success are low.

4th Department of Medicine Charles University Prague Czech Republic