Alterations in calf blood flow following profundaplasty

Abstract

Ten adult males (13 limbs) undergoing profundaplasty were studied. Indications for operation were rest pain in 11 limbs and disabling claudication in 2 limbs. Measurements of calf blood flow (CBF) were performed by venous occlusion plethysmography at rest and during reactive hyperemia (RH) and Doppler ankle systolic blood pressures (DABP) were obtained preoperatively, 3 days, 1 week and 1, 6, and 12 months postoperatively. In nine procedures with successful clinical outcome, mean resting CBF was 3.1 ± 0.2 (SEM) cc/100 ml min -1 preoperatively, while CBF was 3.3 ± 0.3, 3.4 ± 0.4, 3.5 ± 0.5, 3.2 ± 0.3, and 3.8 ± 0.4 cc/100 ml min -1 3 days, 1 week, and 1, 6, and 12 months after operation, respectively. Peak CBF during RH in these cases was 4.5 ± 0.4 cc/100 ml min -1 preoperatively and 5.4 ± 0.4, 5.1 ± 0.6, 6.7 ± 0.6, 8.6 ± 1.2, and 7.9 ± 1.3 cc/100 ml min −1 3 days, 1 week, and 1, 6, and 12 months after operation, respectively. Mean preoperative DABP was 49 mm Hg, while DABP was 45 ± 7, 48 ± 6, 59 ± 6, 71 ± 7, and 69 ± 6 mm Hg 3 days, 1 week, and 1, 6, and 12 months after operation, respectively. In four procedures resulting in no symptomatic improvement, changes in resting CBF, peak CBF during RH, and DABP were not significant. Resting CBF before and after profundaplasty were not significantly different ( P > 0.05). However, peak CBF during RH significantly ( P < 0.05) increased postoperatively at 1 month and this improvement in CBF was sustained during the period of clinical evaluation. Mean resting DABP improved significantly ( P < 0.05) 1 month postoperatively and these changes were maintained during the postoperative period. These initial and sustained increases in CBF and DABP correlate with clinical improvement observed after profundaplasty.