The role of angioplasty of the profunda femoris artery in revascularization of the ischemic limb.

Angioplasty of the profunda femoris should be the primary approach to revascularization of the limb whenever it is feasible. Claudication distance can be significantly improved in almost all patients and prolonged limb salvage achieved in the majority of patients. In some high risk patients, the entire procedure can be accomplished expeditiously and atraumatically under local anesthesia, using a single groin incision. When the pattern of distribution of atherosclerosis provides the surgeon with the choice of performing either angioplasty of the profunda femoris or femoral popliteal bypass, the former option should be tried initially with resort to the latter if ischemia is not adequately relieved. In many instances when distal bypass is not possible or is unlikely to function effectively, angioplasty of the profunda femoris may provide the only opportunity to relieve ischemic symptoms. Operative blood flow measurements support the thesis that the collateral function of the profunda femoris artery is able to compensate for extensive obstructive disease in both the superficial femoral and popliteal segments.