The Role of the Profundoplasty in the Modern Management of Patient with Peripheral Vascular Disease

Taurino, Maurizio; Persiani, Francesca; Ficarelli, Roberta; Filippi, Federico; Dito, Raffaele; Rizzo, Luigi

doi:10.1016/j.avsg.2017.05.018

Cited by 18 publications

(6 citation statements)

References 9 publications

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“…Taurino et al. 18 reported on a similar number of patients to our series undergoing profundoplasty as a sole procedure for revascularization. He concluded that profundoplasty alone was not adequate to prevent major amputation, with further bypass being almost always necessary.…”

Section: Discussionsupporting

confidence: 68%

Clinical outcomes from profundoplasty performed as a sole procedure for revascularization in critically ischaemic limbs

et al. 2020

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Objectives The aim of this study is to investigate the durability and clinical efficacy of profundoplasty as a sole procedure in patients presenting with critical limb ischaemia associated with profunda femoral artery disease and superficial femoral artery occlusion. Methods Retrospective analysis of outcomes from all patients who underwent surgical profundoplasty in a single tertiary referral centre was performed. Patients who presented with either rest pain or tissue loss and had combined profunda femoral artery disease and superficial femoral artery occlusion were included in the study. Outcomes were compared between the rest pain and the tissue loss groups. Results Between 2009 and 2019, 51 procedures were performed in 49 patients; 27 (53%) procedures were performed for rest pain and 24 (47%) for tissue loss. Technical success was 100% in both groups. Procedure success was significantly better in the rest pain group owing to lower procedure-related complications ( p = 0.037). Incidence of major adverse cardiovascular events was higher in the tissue loss group with five reported cases compared to only one in the rest pain group ( p = .05); 85.2% of patients with rest pain experienced clinical improvement compared to only 33.3% in the tissue loss group ( p < .001). Higher rates of re-intervention were recorded in the tissue loss group, but this was not statistically significant. Amputation-free survival at 3, 6 and 12 months was 96%, 96% and 92% in the rest pain group, respectively, compared to 77%, 67% and 54% in the tissue loss group ( p = .004). At one-year, freedom from major adverse limb events was lower in patients with tissue loss at 43% compared to 81% in patients with rest pain ( p = .009). Conclusions Profundoplasty performed as a sole procedure for revascularisation of the critically ischaemic limb is a viable straightforward option. However, our results suggest that it may be more effective in the treatment of rest pain rather than in the setting of tissue loss when a combined superficial femoral artery angioplasty or distal bypass may be required.

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Section: Discussionsupporting

confidence: 68%

Clinical outcomes from profundoplasty performed as a sole procedure for revascularization in critically ischaemic limbs

et al. 2020

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“…To perform revascularization in patients with critical lower limb ischemia, it is possible to apply this method of surgical intervention, however, it is associated with a relatively high frequency of need for additional intervention in the future (freedom from amputations of 40% for 10 years in the presence of trophic changes in the leg). At the same time, within two years, limb preservation was noted in 70% of patients, which is comparable with distal reconstructions [56].…”

supporting

confidence: 65%

“…Для выполнения реваскуляризации у больных с критической ишемией нижних конечностей возможно применять данный метод хирургического вмешательства, однако он сопряжен с относительно высокой частотой потребности в дополнительном вмешательстве в дальнейшем (свобода от ампутаций 40% в течение 10 лет при наличии трофических изменений на ноге). В то же время в течение двух лет сохранение конечности отмечено у 70% больных, что сопоставимо с дистальными реконструкциями [56].…”

Section: Ruunclassified

Limb Revascularization in Patients with Diabetes Mellitus

Bokeria

Бокерия²,

Arakelyan

et al. 2019

Vestn. Ross. univ. družby nar., Ser. Med.

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The review describes morbidity, mortality and possible complication rates for diabetic patients with peripheral arteries disease. The article demonstrates the modern tendency in the surgical treatment of peripheral arteries atherosclerosis, shows and compares worldwide results of endovascular and open revascularization. The authors have assessed the risk of amputation for patients with diffuse peripheral arteries disease and described basic treatment principals for better chronic ischemic ulcer healing.

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“…Independently from the chosen approach, the intention to treat basis was the improvement of distal flow addressing more lesions as possible during the index treatment [ 15 , 16 , 17 , 18 ]. This intention to treat basis had the aim to reduce the levels of amputation turning the initial indications for major amputation into minor amputation ( Figure 6 ).…”

Section: Methodsmentioning

confidence: 99%

The Role of Early Revascularization and Biomarkers in the Management of Diabetic Foot Ulcers: A Single Center Experience

et al. 2022

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Diabetic neuropathy and Peripheral Arterial Disease (PAD) are the main etiological factors in foot ulceration. Herein, we report our experience of diabetic foot ulceration (DFU) management, with an analysis of the relationship between the rate of lower extremity amputation, in persons with infected DFU, after revascularization procedures performed to prevent major amputation. This study highlights the role of different biomarkers, showing their usefulness and potentiality in diabetic foot ulcer management, especially for the early diagnosis and therapy effectiveness monitoring. A retrospective analysis, from September 2016 to January 2021, of diabetic patients presenting diabetic foot with DFU, was performed. All patients were treated with at least one vascular procedure (endovascular, open, hybrid procedures) targeting PAD lesions. Outcomes measured were perioperative mortality and morbidity. Freedom from occlusion, primary and secondary patency, and amputation rate were registered. A total of 267 patients, with a mean age of 72.5 years, were included in the study. The major amputation rate was 6.2%, minor amputation rate was 17%. In our experience, extreme revascularization to obtain direct flow reduced the rate of amputations, with an increase in ulcer healing.

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The Role of the Profundoplasty in the Modern Management of Patient with Peripheral Vascular Disease

Cited by 18 publications

References 9 publications

Clinical outcomes from profundoplasty performed as a sole procedure for revascularization in critically ischaemic limbs

Clinical outcomes from profundoplasty performed as a sole procedure for revascularization in critically ischaemic limbs

Limb Revascularization in Patients with Diabetes Mellitus

The Role of Early Revascularization and Biomarkers in the Management of Diabetic Foot Ulcers: A Single Center Experience

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