title: Does deep femoral artery revascularization as an isolated procedure play a role in chronic critical limb ischemia?
abstract: OBJECTIVE
  To prospectively evaluate the midterm outcome after balloon angioplasty or surgical profundaplasty of the deep femoral artery (DFA) as an isolated procedure in chronic critical limb ischemia (CLI).
  
  
  METHODS
  Between 1995 and 2001, 21 limbs in 20 patients (mean age 77+/-8 years) were treated by revascularization of the deep femoral artery (DFA) as an isolated procedure for limb salvage. All patients had long-segment femoropopliteal occlusions unsuitable for revascularization and critical obstruction of the DFA. Clinical outcome was assessed at 1, 3, 6, and 12 months. Clinical treatment efficacy was defined as resolved CLI in surviving patients without major amputation after isolated DFA revascularization. Repeat target limb revascularization, major amputation, and death were solitary study endpoints; survival analyses were performed using the Kaplan-Meyer method.
  
  
  RESULTS
  Angioplasty with or without stenting was performed in 14 (67%) limbs and surgical profundaplasty in 7 (33%) limbs, with a technical success rate of 100%. Clinical treatment efficacy was 25% at 12 months; the cumulative rates of repeat target limb revascularization, major amputation, and death were 49%, 36%, and 55%, respectively. Major amputation and persistent CLI dominated in patients with stage IV disease (89%), whereas rest pain resolved in the majority of patients with stage III disease (67%; p<0.05).
  
  
  CONCLUSIONS
  Isolated DFA revascularization seems insufficient to support wound healing in CLI, but might be a treatment option in CLI patients with rest pain.
authors.affiliation: Division of Angiology, Swiss Cardiovascular Centre, University Hospital, Freiburgstrasse, 3010 Bern, Switzerland.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Diehm
authors.forename: Hannu
authors.initials: H
authors.lastname: Savolainen
authors.forename: Felix
authors.initials: F
authors.lastname: Mahler
authors.forename: Jürg
authors.initials: J
authors.lastname: Schmidli
authors.forename: Do-Dai
authors.initials: DD
authors.lastname: Do
authors.forename: Iris
authors.initials: I
authors.lastname: Baumgartner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D002908:Chronic Disease; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D011859:Radiography; D012307:Risk Factors; D015607:Stents