Ectasia of the Profunda Femoris Artery: A Late, Serious Complication of Isolated Profundaplasty

Abstract

The merits of isolated profundaplasty remain controversial, because of many variables in patient selection and operative technique, including or not concomitant inflow procedures. This report deals with a homogeneous group of 11 male patients, aged forty-seven to seventy-two years, who underwent isolated profundaplasty for limb salvage and were thereafter available for follow-up. The check-up protocol included echographic examination of the femoral region, in order to detect any aneurysm formation of the reconstructed vessel. A fe morodistal bypass was judged unsuitable in all cases, because of severity of the atherosclerotic disease involving popliteal and tibial arteries. The cumulative limb salvage rate was 63% at two years and 54% at five and ten years. Five reconstructions failed within four years after surgery. Four patients died two to eight years following profundaplasty. An aneurysm of the reconstructed pro funda femoris artery was diagnosed in 1 patient three years after surgery. Ten months later the patient presented with a gangrenous forefoot and underwent below-knee amputation. In conclusion, isolated profundaplasty may achieve an acceptable limb salvage rate, even in patients with a poor distal vascular bed. Ectasia of the reconstructed profunda artery represents a potential, serious complication.