Extended profundoplasty to minimize pelvic and distal tissue loss

William Edwards, J. M. Jenkins, J. L. Mulherin, R. S. Martin, W. H. Edwards

    Research output: Contribution to journalArticle

    8 Citations (Scopus)

    Abstract

    Multiple levels of aortoileofemoral occlusive disease may necessitate profundoplasty or extension of the outflow anastomosis to insure pelvic and distal arterial perfusion. During the period 1978 through 1988, 1637 patients underwent elective aortic reconstruction for aneurysmal or occlusive disease. One hundred forty-five had profundoplasty performed to ensure adequate outflow. Associated disease was common with 88 (60%) patients having arteriosclerotic heart disease and chronic obstructive pulmonary disease (COPD) present in 89 (61%) patients. Hypertension and extracranial occlusive diseae was found in 68 (46%) and 56 (38%) patients, respectively. The superficial femoral artery was occluded in 108 (74%) patients, while in 17 (12%) the profunda femoris was the only patent artery in the groin. Death occurred in nine patients (6.2%). Three were due to arrhythmias or myocardial infarction and ischemic colitis was the cause of death in two. Renal failure, sepsis, aspiration and cerebral anoxia, and disseminated intravascular coagulopathy accounted for one each. Five graft limbs failed. Amputation was required in one patient, while thrombectomy or distal bypass restored flow in four patients. Seventeen graft limbs in 136 patients occluded during the follow-up period. Distal bypass was successful in four and amputation was required in the fifth patient. Extension of the profundoplasty restored flow in nine limbs, while thrombectomy alone was successful in one. Bilateral amputation was required in one patient with poor run off and insufficient autogenus venous tissue. One hundred fourteen (78.6%) of the 145 patients survived 10 years with patency in 268 of the original 290 limbs at risk (92.4%). Profundoplasty in these patients with multilevel disease seems to extend the long-term patency of aortofemoral grafts and allows return to a normal live-style.

    Original languageEnglish (US)
    Pages (from-to)694-702
    Number of pages9
    JournalAnnals of surgery
    Volume211
    Issue number6
    DOIs
    StatePublished - Jan 1 1990

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    Extremities
    Amputation
    Thrombectomy
    Transplants
    Ischemic Colitis
    Brain Hypoxia
    Groin
    Femoral Artery
    Chronic Obstructive Pulmonary Disease
    Renal Insufficiency
    Cardiac Arrhythmias
    Cause of Death
    Heart Diseases
    Sepsis
    Arteries
    Perfusion
    Myocardial Infarction
    Hypertension

    All Science Journal Classification (ASJC) codes

    • Surgery

    Cite this

    Edwards, W., Jenkins, J. M., Mulherin, J. L., Martin, R. S., & Edwards, W. H. (1990). Extended profundoplasty to minimize pelvic and distal tissue loss. Annals of surgery, 211(6), 694-702. https://doi.org/10.1097/00000658-199006000-00007

    Extended profundoplasty to minimize pelvic and distal tissue loss. / Edwards, William; Jenkins, J. M.; Mulherin, J. L.; Martin, R. S.; Edwards, W. H.

    In: Annals of surgery, Vol. 211, No. 6, 01.01.1990, p. 694-702.

    Research output: Contribution to journalArticle

    Edwards, W, Jenkins, JM, Mulherin, JL, Martin, RS & Edwards, WH 1990, 'Extended profundoplasty to minimize pelvic and distal tissue loss', Annals of surgery, vol. 211, no. 6, pp. 694-702. https://doi.org/10.1097/00000658-199006000-00007
    Edwards W, Jenkins JM, Mulherin JL, Martin RS, Edwards WH. Extended profundoplasty to minimize pelvic and distal tissue loss. Annals of surgery. 1990 Jan 1;211(6):694-702. https://doi.org/10.1097/00000658-199006000-00007
    Edwards, William ; Jenkins, J. M. ; Mulherin, J. L. ; Martin, R. S. ; Edwards, W. H. / Extended profundoplasty to minimize pelvic and distal tissue loss. In: Annals of surgery. 1990 ; Vol. 211, No. 6. pp. 694-702.
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