I read with interest the article 'Lower limb ischaemia
complicating transcatheter embolization of arteriovenocaliceal
fistula' by Jawad, et al. (Saudi Med J 1993; 14: 252-254).
Certainly, the authors should be congratulated for their
successful efforts to save the limb of their young patient.
However, I am not sure whether the additional procedure of
profundoplasty was indicated or even justified.
Profundoplasty is a procedure with limited value and is
usually done in chronically ischaemic limbs due to mainly
stenosis of the proximal portion of the deep femoral
artery.I.2·3 Frequently, it is performed as an adjunctive
procedure to a distal femoropopliteal bypass. The authors did
it as an isolated procedure which I think is a very uncommon
vascular procedure in current practice.
To the best of my knowledge, it has no indication in acutely
ischaemic limbs due to straightforward thromboembolism.
Perhaps there were some other indications.