Extended profundoplasty for limb salvage.

Extended profundoplasty was performed in 50 limbs of 39 patients for relief of rest pain or gangrene. This operation was effective in 95% of the limbs operated on because of rest pain, and in 54.5% of the limbs operated on because of gangrene. In 32 limbs the popliteal artery was patent. Profundoplasty was successful in relieving ischemic symptoms in all but two limbs. Postoperative ankle pressures were increased consistently in the improved limbs. In 18 limbs the popliteal artery was occluded. Profundoplasty abolished the ischemic symptoms in 13 limbs. Ankle pressures did not increase consistently in limbs that were clinically improved in this group. The authors believe that restoring blood flow and pressure to the profunda femoris artery and its branches, by means of open endarterectomy and patch graft, can salvage limbs which otherwise would be fated for amputation. As such, it represents a reasonable alternative to bypass grafting, and in some cases it is the procedure of choice for the patient with threatened tissue loss.