[Possibilities and limits of angiographic exploration of the deep femoral artery using posteroanterior projections as described by Dos Santos. Radiological and therapeutic consequences (author's transl)].
The study concerns 36 patients treated by an aortobifemoral shunt operation. The decision to operate followed conventional posteroanterior arteriography using the technique described by Dos Santos. Surgical exploration of 54 deep femoral arteries (DF) was conducted during the approach to the femoral tripod. Anatomical findings were 40 significant stenoses of the DF, 4 complete obstructions, and 10 normal arteries. These observations were compared with radiological findings: in 34 cases there was correlation between the results, in 13 cases a false negative was noted, arteriography underestimating the lesions, and in 6 cases a false positive result overestimated the extent of the atheromatous lesion. The lack of sensitivity of standard examinations of the deep femoral arteries means that it is essential to conduct oblique projections in most cases. In certain special cases, however, the authors feel that these complementary examinations can be avoided, thus eliminating their constraints. In fact, when posteroanterior angiography suggests the need for operation by an aorto-bifemoral shunt, systematic exploration of the femoral tripods can, according to the authors, replace oblique projection images. Apart from these favourable cases, oblique projections are essential during pre-operative investigations. They are also necessary to exclude any possibility of direct revascularization.