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In the Patient with Profunda Artery Disease, Is Open Revascularization Superior to Endovascular Repair for Improving Rest Pain?

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Difficult Decisions in Vascular Surgery

Part of the book series: Difficult Decisions in Surgery: An Evidence-Based Approach ((DDSURGERY))

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Abstract

The profunda femoris artery is the major collateral source of blood supply to the lower leg in patients with atherosclerotic obstruction of the superficial femoral artery. Open revascularization of the profunda is beneficial for patients with chronic limb ischemia, as technical success rates are high and durable patency has been demonstrated in a number of studies. However, there are strong advocates for increased use of endovascular techniques in the common femoral and profunda segments, reserving open surgery for patients who have failed catheter-based treatment. From currently available data, which consists almost entirely of retrospective analyses with the exception of one relatively small prospective randomized trial, we recommend that patients who are able to tolerate open surgery, do not have a hostile groin due to current or past infection or imbedded prosthetic material, and are not morbidly obese should preferably undergo open common femoral endarterectomy/profundaplasty as indicated. Endovascular therapy is a suitable option in those unable to tolerate open surgery, or in those with the aforementioned mitigating factors.

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Author information

Authors and Affiliations

  1. Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, University of Chicago, Chicago, IL, USA

    Jordan R. Stern MD & Victor M. Bernhard MD

Authors
  1. Jordan R. Stern MD
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  2. Victor M. Bernhard MD
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Correspondence to Victor M. Bernhard MD .

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Editors and Affiliations

  1. The University of Chicago Medical Center and Biological Science Division, Chicago, Illinois, USA

    Christopher L. Skelly

  2. The University of Chicago Medical Center and Biological Science Division, Chicago, Illinois, USA

    Ross Milner

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Stern, J.R., Bernhard, V.M. (2017). In the Patient with Profunda Artery Disease, Is Open Revascularization Superior to Endovascular Repair for Improving Rest Pain?. In: Skelly, C., Milner, R. (eds) Difficult Decisions in Vascular Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach. Springer, Cham. https://doi.org/10.1007/978-3-319-33293-2_16

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  • DOI: https://doi.org/10.1007/978-3-319-33293-2_16

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  • Online ISBN: 978-3-319-33293-2

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