Percutaneous profundaplasty in the treatment of lower extremity ischemia: results of long-term surveillance.
OBJECTIVE
To assess the procedural and long-term clinical outcomes of balloon angioplasty of the profunda femoris artery in patients with severe limb ischemia.


METHODS
Thirty-one consecutive patients were evaluated for severe ischemia in 32 limbs: 13 (41%) were categorized Fontaine class 2B, and 19 (59%) were class 3 or 4. The superficial femoral artery was occluded in 20 (62%) limbs; an additional vessel was treated in 22 (69%) limbs.


RESULTS
Procedural success was achieved in 91% (31/32) of limbs. The ankle-brachial index increased from 0.5 +/- 0.2 at baseline to 0.7 +/- 0.2 after intervention (p < 0.01). In-hospital limb salvage was 94% (30/32), and in-hospital event-free survival was 90% (28/31). At a mean follow-up of 34 +/- 20 months, no additional amputations were necessary; 3 patients required repeat revascularization, and 5 patients died. Freedom from revascularization was 88% in the 25 survivors. At follow-up, 88% of the patients had Fontaine class 1 or 2A symptoms, and only 12% had Fontaine class 2B or higher (p < 0.001 compared with baseline).


CONCLUSIONS
These data suggest that percutaneous profundaplasty is safe, effective, and may be considered as an alternative to surgical therapy in patients with anatomically suitable lesions.
Silva
J A
JA
Department of Cardiology, Ochsner Clinic, and the Alton Ochsner Medical Foundation, New Orleans, Louisiana 70121, USA.
White
C J
CJ
Ramee
S R
SR
Collins
T J
TJ
Jenkins
J S
JS
Sabet
S
S
Shamaileh
Q
Q
Vivekananthan
K
K
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D015906:Angioplasty, Balloon, Coronary; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D019233:Retreatment; D016019:Survival Analysis