Profundaplasty: its role in limb salvage.
The concept of the profunda artery as a collateral system is very useful in determining which patients may benefit from profundaplasty. When hemodynamic profunda stenosis is associated with combined aortoiliac and superficial femoral artery occlusive disease, profundaplasty as an adjunct to an arterial inflow procedure is highly successful. It is most efficacious when performed for disabling intermittent claudication and less successful for limb salvage indications. When isolated profundaplasty is performed for limb salvage, it may be an appropriate first procedure to heal ischemic ulcers and relieve rest pain. Ischemic gangrene is less frequently resolved and may require distal bypass. However, if the PPCI is low and/or the arteriographic appearance of the profunda system is favorable, then isolated profundaplasty may be successful. When limb salvage is precluded by extensive pedal necrosis or end-stage arterial disease, profundaplasty may provide effective perfusion of the knee joint so that a more functional below-knee amputation may be performed.
D000671:Amputation, Surgical; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D003097:Collateral Circulation; D005263:Femoral Artery / Q000033:anatomy & histology / Q000601:surgery*; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply* / Q000601:surgery