title: Percutaneous profunda femoris artery revascularization to prevent hip disarticulation: case series and review of the literature.
abstract: BACKGROUND
  Little is known about the role of percutaneous revascularization of the profunda femoral artery (PFA) in patients with amputation stump ischemia who are at risk of hip disarticulation.
  
  
  METHODS
  We identified 4 patients who were treated for persistent amputation stump ischemia by PFA percutaneous revascularization over a 3-year period. All 4 patients had significant cardiopulmonary comorbidities and 2 patients had at least 3 previous groin surgeries. The short- and long-term outcomes of the patients were evaluated with regard to stump salvage, wound healing rate, complications, and mortality rate.
  
  
  RESULTS
  Technical success was 100% with no procedure-related complications. All 4 patients had multilevel vascular disease involving the iliac, common femoral artery, and the profunda femoral artery. All 4 patients were treated with angioplasty and/or stenting of the PFA. The amputation stump was closed primarily in 3 patients and 1 amputation stump was closed with a skin graft. One patient died during the same hospital stay shortly after declining hemodialysis. Three patients are alive at a mean follow-up period of 9 months (range, 5-14 mo).
  
  
  CONCLUSIONS
  Percutaneous PFA revascularization should be considered, over open revascularization, in patients with persistent above-knee amputation stump ischemia and multiple previous groin surgeries to avoid hip disarticulation.
authors.affiliation: Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA.
authors.forename: Mun Jye
authors.initials: MJ
authors.lastname: Poi
authors.forename: George
authors.initials: G
authors.lastname: Pisimisis
authors.forename: Neal R
authors.initials: NR
authors.lastname: Barshes
authors.forename: Peter H
authors.initials: PH
authors.lastname: Lin
authors.forename: Panos
authors.initials: P
authors.lastname: Kougias
authors.forename: Carlos F
authors.initials: CF
authors.lastname: Bechara
mesh_terms: D000368:Aged; D000672:Amputation Stumps / Q000098:blood supply*; D017130:Angioplasty; D004188:Disarticulation; D005263:Femoral Artery; D006621:Hip Joint / Q000601:surgery; D006801:Humans; D007511:Ischemia / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome