Percutaneous profunda femoris artery revascularization to prevent hip disarticulation: case series and review of the literature.

Abstract:

BACKGROUND:Little is known about the role of percutaneous revascularization of the profunda femoral artery (PFA) in patients with amputation stump ischemia who are at risk of hip disarticulation. METHODS:We identified 4 patients who were treated for persistent amputation stump ischemia by PFA percutaneous revascularization over a 3-year period. All 4 patients had significant cardiopulmonary comorbidities and 2 patients had at least 3 previous groin surgeries. The short- and long-term outcomes of the patients were evaluated with regard to stump salvage, wound healing rate, complications, and mortality rate. RESULTS:Technical success was 100% with no procedure-related complications. All 4 patients had multilevel vascular disease involving the iliac, common femoral artery, and the profunda femoral artery. All 4 patients were treated with angioplasty and/or stenting of the PFA. The amputation stump was closed primarily in 3 patients and 1 amputation stump was closed with a skin graft. One patient died during the same hospital stay shortly after declining hemodialysis. Three patients are alive at a mean follow-up period of 9 months (range, 5-14 mo). CONCLUSIONS:Percutaneous PFA revascularization should be considered, over open revascularization, in patients with persistent above-knee amputation stump ischemia and multiple previous groin surgeries to avoid hip disarticulation.

journal_name

Am J Surg

authors

Poi MJ,Pisimisis G,Barshes NR,Lin PH,Kougias P,Bechara CF

doi

10.1016/j.amjsurg.2012.07.001

subject

Has Abstract

pub_date

2012-11-01 00:00:00

pages

649-54

issue

5

eissn

0002-9610

issn

1879-1883

pii

S0002-9610(12)00347-9

journal_volume

204

pub_type

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