In chronic lower limb ischemia, the deep femoral artery plays a significant role in compensating for blood circulation due to the developed collateral branches providing the blood supply to the entire limb when a superficial femoral artery occluded. Surgical plasty of the deep femoral artery, profundaplasty, has been established as a technique having long-term patency results, significantly superior to bypass operations on the femoral-popliteal-tibial segment, as well as endovascular operations. However, the clinical effectiveness of isolated deep femoral artery is often questioned, especially in patients with critical ischemia. Nowadays there are no instrumental methods to reliably assess the quality of collaterals preoperatively. The article provides an overview of published data concerning different methods of profundaplasty improving effectiveness of surgical strategy through various technical modifications. Also it is introduced the role of the plain balloon angioplasty and stenting of the deep femoral artery. It also describes existing methods for isolated profundoplasty effectiveness preoperative evaluation.

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