The role of isolated profundaplasty for the treatment of rest pain.

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.