Is Profunda Revascularisation Enough in Limb Salvage?

Abstract

Aim: To evaluate the effects of profunda revascularisation in patients with critical limb ischaemia. Method: A retrospective cohort study, of consecutive patient over a 2-year period, selected based on the presence of critical limb ischaemia (rest-pain or minor tissue loss pre-operatively). The benefits of three revascularisa tion procedures targeting the profunda femoris artery were assessed: common femoral endarterectomy with profundaplasty(CFE), femoral femoral crossover with profundaplasty (FFXO) and axillo-bifemoral bypass with profundaplasty (AxBiF). Demographics, ABPI and clinical outcome were obtained. Result: 41 patients recruited; the group with pre-op rest-pain (n¼18) were subdivided into CFE (n¼10), FFXO (n¼5) and AxBiF (n¼3) and compared to the group with pre-op minor tissue loss undergoing CFE (n¼18), FFXO (n¼4) and AxBiF (n¼1). In the rest-pain group symptomatic relief was acheived in 17 patients (94%). In comparison, the group with minor tissue loss showed tissue healing in 74% (n¼17). ABPI measurements recorded from 7 patients (17%) all showing improvement post-op; mean improvement in ABPI of 0.3 and a range of 0.18-0.51. Conclusion: Profunda revascularisation enables symptomatic relief and limb salvage.