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The current role of isolated profundaplasty
P G Kalman1, K W Johnston, P M Walker
1Division of Vascular Surgery, Toronto General Hospital, University of Toronto, Ontario, Canada.
The Journal of Cardiovascular Surgery
|January 1, 1990
Summary
Isolated profundaplasty offers a viable revascularization option for the lower limb. Good tibial outflow and early ankle-brachial index improvement predict successful long-term outcomes, making it a valuable surgical choice.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
Background:
- Divergent opinions exist regarding the efficacy of isolated profundaplasty.
- A comprehensive review of long-term outcomes is necessary to clarify its role.
Purpose of the Study:
- To evaluate the long-term clinical success of isolated profundaplasty.
- To identify predictors of success for this revascularization procedure.
Main Methods:
- Retrospective review of patient outcomes over a 10-year period.
- Analysis of cumulative clinical success rates, including patient repair and clinical improvement.
- Assessment of factors influencing long-term success, such as tibial outflow and ankle-brachial index (ABI) changes.
Main Results:
- Cumulative clinical success rates were 83% at 30 days, decreasing to 49% at three years.
- Optimal outcomes were observed in patients with good tibial outflow (2-3 patent vessels).
- An early postoperative ABI improvement > 0.10 predicted long-term success.
Conclusions:
- Isolated profundaplasty serves as a beneficial alternative for lower limb revascularization.
- The procedure does not impede potential future distal reconstruction.
- Patient selection based on tibial outflow and early ABI response is crucial for optimizing results.