The role of isolated profundaplasty for the treatment of rest pain
D. M. McCoy, A. P. Sawchuk, J. J. Schuler, J. R. Durham, J. Eldrup-Jorgensen, T. H. Schwarcz, J. P. Meyer and D. P. Flanigan
Department of Surgery, University of Illinois College of Medicine, Chicago 60612.
This study was undertaken to determine the efficacy and durability of
profundaplasty and define preoperative factors predictive of success. The
hospital charts, vascular laboratory data, and arteriograms of 20 patients
having 21 isolated profundaplasties for ischemic rest pain between 1979 and
1987 were reviewed. Follow-up extended to 72 months (mean, 26 months).
Early success was achieved in 12 extremities (57%) and life-table analysis
showed continued success to six years in 11 extremities (55%). Of the
multiple preoperative factors assessed, only a low-thigh/ankle gradient
pressure index (TAGI) of less than 0.55 was predictive of success.
Life-table analysis for limbs with a TAGI of less than 0.55 showed an 89%
success rate at six years compared with only a 32% success rate for limbs
with a TAGI of more than 0.55. Isolated profundaplasty for the treatment of
ischemic rest pain can be an efficacious and durable procedure when
patients are selected based on objective hemodynamic measurements.
