Percutaneous profundaplasty in the treatment of lower extremity ischemia: Results of longterm surveillance

Purpose: To assess the procedural and long-term clinical outcomes of balloo n angioplasty of the profunda femoris artery in patients with severe limb i schemia. Methods: Thirty-one consecutive patients were evaluated for severe ischemia in 32 limbs: 13 (41%) were categorized Fontaine class 2B, and 19 (59%) wer e class 3 or 4. The superficial femoral artery was occluded in 20 (62%) lim bs; 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 r epeat revascularization, and 5 patients died. Freedom from revascularizatio n was 88% in the 25 survivors. At follow-up, 88% of the patients had Fontai ne 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, e ffective, and may be considered as an alternative to surgical therapy in pa tients with anatomically suitable lesions.