Abstract
By use of direct surgical procedures, including endarterectomy and patch angioplasty, the reconstructed profunda femoris artery has been employed to treat symptoms of claudication from femoral-popliteal occlusive disease and to facilitate healing of ampu tations that spare the knee joint. As the techniques of distal arterial bypass have become more sophisticated with improved long-term patency, the role of profun daplasty has changed.
Sixty-eight reconstructions of the profunda femoris artery were reviewed for 51 patients with limb-threatening ischemia (69%), claudication (28%), or infected pros thetic vascular grafts (3%). Thirty-three (49%) of the limbs had undergone 73 prior arterial reconstructions. Forty-nine patients had inflow procedures performed at the time of the profundaplasty, and 13 had concomitant reconstruction of arterial outflow. In only 6 cases was the procedure an isolated profundaplasty. Successful profun daplasty was defined as primary patency of the vascular reconstruction.
By life table analysis, revascularizations utilizing profundaplasty had a primary patency of 81% at one year, 64% at two years, and 54% at four years. The series achieved a limb salvage rate of 96% at four years.
Isolated profundaplasty is seldom utilized to treat critical ischemia of the lower extremity. The current role of profundaplasty places the procedure as an important adjunct to achieve long-term limb salvage and patency of complex vascular reconstructions.
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