Percutaneous Profundaplasty in the Treatment of Lower Extremity Ischemia: Results of Long-term Surveillance

Abstract

Purpose: To assess the procedural and long-term clinical outcomes of balloon angioplasty of the profunda femoris artery in patients with severe limb ischemia. Methods: Thirty-one consecutive patients were evaluated for severe ischemia in 32 limbs: 13 (41%) were categorized Fontaine class 2B, and 19 (59%) were class 3 or 4. The superficial femoral artery was occluded in 20 (62%) limbs; an additional vessel was treated in 22 (69%) limbs. Results: Procedural success was achieved in 91% (31/32) of limbs. The ankle-brachial index increased from 0.5 ± 0.2 at baseline to 0.7 ± 0.2 after intervention (p < 0.01). In-hospital limb salvage was 94% (30/32), and in-hospital event-free survival was 90% (28/31). At a mean follow-up of 34 ± 20 months, no additional amputations were necessary; 3 patients required repeat revascularization, and 5 patients died. Freedom from revascularization was 88% in the 25 survivors. At follow-up, 88% of the patients had Fontaine class 1 or 2A symptoms, and only 12% had Fontaine class 2B or higher (p < 0.001 compared with baseline). Conclusions: These data suggest that percutaneous profundaplasty is safe, effective, and may be considered as an alternative to surgical therapy in patients with anatomically suitable lesions.