Profunda femoris revascularization in limb salvage.
A retrospective study of 282 profunda femoris artery reconstructions between 1971 and 1981 with follow-up at least two years in 212 (75.1%) is presented. Arteriographic evaluation was performed in 92 cases. Stages III and IV were the indication for revascularization in 86% of cases. An inflow correction was necessary in 60.3% of profunda reconstructions. Factors that bear on the success or failure of profundaplasty were evaluated. These were aorto-iliac inflow, the extent of disease in the profunda femoris artery, the run-off in the distal popliteal-tibial system and the extent of the ischemic lesion. Of the failures most were due to established gangrene, obstructions throughout the whole length of the profunda or patients with a poor popliteal-tibial run-off system. The cumulative limb salvage at two years was 86.8% in limbs subjected to inflow correction procedure and profundaplasty but only in 56.5% of repair of the profunda alone. In the majority of the below-knee amputations after profundaplasty, repair of the profunda was used to lower the level of amputation from above knee to below the knee. Profundaplasty is worth considering even in those patients who cannot be offered other revascularization surgery.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged