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Efficacy of isolated profundaplasty.

A M Graham, B L Gewertz, C K Zarins

Canadian Journal of Surgery. Journal Canadien De Chirurgie

|September 1, 1986

Summary

Profundaplasty effectively treats aortofemoral graft failure but is not recommended for isolated limb salvage. Angiographic criteria failed to reliably predict success in patients undergoing profundaplasty alone.

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Area of Science:

Vascular Surgery
Interventional Cardiology

Background:

Profundaplasty is utilized for aortofemoral graft complications and as a primary treatment for severe limb ischemia.
Its efficacy as an isolated procedure for limb salvage remains debated.

Purpose of the Study:

To evaluate the outcomes of profundaplasty in patients with threatened aortofemoral graft failure versus isolated limb ischemia.
To assess the predictive value of preoperative angiographic criteria for profundaplasty success.

Main Methods:

Retrospective review of 27 patients undergoing profundaplasty (1978-1983).
Patients were divided into two groups: threatened graft failure (n=5) and isolated limb ischemia (n=22).
Preoperative angiograms were analyzed for five specific criteria predictive of favorable outcomes.

Main Results:

Profundaplasty achieved 100% success in patients with threatened graft failure.
Only 14% of patients undergoing isolated profundaplasty for limb salvage experienced symptom relief or lesion healing.
64% of patients in the isolated limb salvage group required major amputation.

Conclusions:

Profundaplasty is a valuable outflow procedure for aortofemoral grafts but is not recommended as an isolated treatment for limb salvage.
Preoperative angiographic criteria are not reliable in identifying patients who will benefit from isolated profundaplasty.
The primary role of profundaplasty is to enhance outflow for aortic grafts.

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