In Reply.—I and my colleagues appreciate the analysis of Dr Edwards and his criticism of our recently described technique. We certainly agree that an aortofemoral prosthetic bypass with extension of the toe of the graft into the profunda, with or without an associated endarterectomy, is an acceptable and successful procedure. As we stated in our report, this procedure is not advocated as "a first line of defense for the proximal profunda stenosis" where profundaplasty by whatever method (prosthetic, artery, or vein patch) can be quite successful, but reserve the superficial femoroprofunda transposition for the long (> 5 cm) stenotic profunda that would require a long "patch angioplasty," in the belief that our presented procedure significantly reduces the operating time with a highly successful clinical result.
We also agree that aortoiliac endarterectomy has "limited indications." We presented the paragraph on aortoiliac endarterectomy only to elicit the problems inherent to that