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Isolated profundaplasty for limb salvage.

D L Rollins, J B Towne, V M Bernhard

    Journal of Vascular Surgery
    |July 1, 1985
    PubMed
    Summary
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    Profundaplasty effectively treats severe leg artery blockages for limb salvage. It offers a viable alternative to amputation, preserving knee function and enabling ambulation, especially when combined with below-knee amputation.

    Area of Science:

    • Vascular Surgery
    • Reconstructive Surgery
    • Peripheral Artery Disease

    Background:

    • Severe stenosis of the deep femoral artery (DFA) and superficial femoral artery (SFA) occlusive disease significantly impacts limb viability.
    • Limb salvage in patients with critical limb ischemia remains a significant clinical challenge.

    Purpose of the Study:

    • To evaluate the efficacy of profundaplasty as a primary limb salvage procedure in patients with severe femoropopliteal occlusive disease.
    • To assess the long-term patency rates and functional outcomes following profundaplasty.

    Main Methods:

    • Fifty-six profundaplasties were performed on 54 patients with >50% DFA stenosis and SFA occlusive disease.
    • Outcomes including ulcer healing, rest pain relief, necrosis healing, arterial patency, and limb salvage were retrospectively analyzed.

    Related Experiment Videos

  • The profundapopliteal collateral index (PPCI) was used to predict limb salvage.

    • Main Results:

    • Profundaplasty resulted in ulcer healing in 53%, rest pain relief in 32%, and necrosis healing in 35% of patients.
    • Cumulative deep femoral artery patency was 49% at 3 years and 21% at 5 years, with limb salvage rates of 49% and 36%, respectively.
    • A PPCI ≤ 0.19 accurately predicted limb salvage (91%), while other clinical factors lacked predictive value.

    Conclusions:

    • Isolated profundaplasty is an effective initial procedure for selected limb salvage candidates, offering an alternative to amputation or high-risk bypass.
    • Effective profunda femoris artery perfusion is crucial for knee joint preservation and functional rehabilitation when amputation is necessary.
    • Profundaplasty facilitates below-knee amputations, enabling high rates of prosthetic ambulation (84%).