Percutaneous Deep Venous Arterialization for Severe Critical Limb Ischemia in Patients With No Option of Revascularization: Early Experience From Two European Centers

Giudice, Costantino Del; Heuvel, D. Van Den; Wille, Jan; Mirault, Tristan; Messas, Emmanuel; Ferraresi, Roberto; Kum, Steven; Sapoval, M.

doi:10.1007/s00270-018-2020-2

Cited by 39 publications

(29 citation statements)

References 12 publications

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“…Our results are comparable to other deep vein arterialization techniques, both percutaneous 7 and surgical. 11 Moreover, as also demonstrate in other percutaneous clinical series, the procedure is safe 6,7 with no perioperative death; in our series, there have been only 3 deaths with no correlation to AVF creation.…”

Section: Discussionsupporting

confidence: 85%

“…TcPO2 levels was recorded in all patients with a median number of measurements per patients of 12 (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). Median value increased from 8 + 2 mmHg (4-32 mmHg) before the AVF creation to 56 + 4 mmHg (48-75 mmHg) at 6 months after the procedure.…”

Section: Resultsmentioning

confidence: 99%

“…5 Since wound healing in CLI patients may be difficult, several endovascular experiences, performing distal anastomoses at the malleolar level, had been published on small number of patients. 6,7 A new percutaneous technique to create an AVF using an intravascular ultrasound (IVUS) image guided system had been proposed 8 ; the aim of this article is to present our experience in AVF creation with an IVUS guided catheter for deep venous arterialization in no-option CLI patients.…”

Section: Introductionmentioning

confidence: 99%

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Percutaneous Deep Foot Vein Arterialization IVUS-Guided in No-Option Critical Limb Ischemia Diabetic Patients

Cangiano

Corvino

Giurazza

et al. 2020

Vasc Endovascular Surg

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Purpose: To report our clinical experience with IVUS-guided percutaneous deep vein arterialization (pDVA) to treat chronic critical limb ischemia (cCLI) patients with no-endovascular or surgical options approach due to creation of an arteriovenous fistula (AVF). Materials and Methods: In a 2 years period, 14 no-option cCLI patients were treated with percutaneous deep vein arterialization (pDVA) by creating an AVF with a IVUS-guided system between posterior tibial artery and its satellite deep vein. Technical success was defined as successful AVF creation and venous perfusion of the wound site. Patients’ characteristics, procedure details, mortality and wound outcomes were assessed prospectively. Results: Successful pDVA was successfully performed in all patients (mean age 82 years) without any procedural complications. Clinical improvement was achieved in all patients with resolution of rest pain, tissue formation of granulation tissue or both; only 3 major amputations were performed within the study period with a limb salvage rate of 78%. Median wound healing time was 4.8 months. Conclusion: pDVA is a safe and feasible revascularization technique alternative in no-option cCLI patients.

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Section: Discussionsupporting

confidence: 85%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Percutaneous Deep Foot Vein Arterialization IVUS-Guided in No-Option Critical Limb Ischemia Diabetic Patients

Cangiano

Corvino

Giurazza

et al. 2020

Vasc Endovascular Surg

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“…[24][25] has shown Deep venous arterialization (DVA) promising results in patients of CLI to prevent major amputation and it is a feasible and safe alternative. [26][27]It enables wound healing by providing arterialized blood.…”

Section: Evolving Treatment Optionsmentioning

confidence: 99%

Current Trends in Critical Limb Ischemia - Review

Agarwal¹,

Vasuniya²

2020

ijsr

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Critical limb ischemia (CLI) is considered the most severe clinical manifestation of peripheral artery disease (PAD). These patients carry high risk of amputation and mortality. CLI patientfaces may problems like restriction of movement, starvation of services and depression. Therapeutic goals in treating these patients include relieving ischemic pain, reducing cardiovascular risk factors, preventing major amputation, improving quality of life and increasing survival.Revascularization is the primary treatment strategy in critical limb ischemia patients. Many patients are not treatable by conventional techniques.This review article provides a comprehensive summary that includes current trends in the management of Critical limb ischemia like endovascular revascularization,gene and cell based therapies and drug eluting stents (DESs) etc.

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“…Deep venous arterialization (DVA) has also been shown to be a safe and feasible novel alternative to prevent major amputation in no-option CLI patients. [5354] It acts by providing arterialized blood at significant pressure and volumes to the ischemic tissue, thereby enabling wound healing. The LimFlow device (LimFlow SA) is currently the only registered device for total percutaneous DVA, which allows for disruption of the veins with a dedicated valvulotome, in addition to percutaneous creation of an arteriovenous fistula.…”

Section: Arterialization Of Deep Veinsmentioning

confidence: 99%

Current review with evolving management strategies in critical limb ischemia

Sharma

2019

Indian Journal of Radiology and Imaging

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Critical limb ischemia represents the end stage of peripheral artery disease, which is associated with impaired quality of life and considerable morbidity and mortality. Economical impact of the disease is huge with a substantial burden on patients, healthcare providers, and resources. Varied therapeutic strategies have been employed in the management of these patients. These patients usually have complex multilevel occlusive arteriopathy with significant comorbidities, rendering surgical interventions undesirable in many cases. Recent therapeutic advances with evolving endovascular techniques and gene or cell-based therapies have the potential to dramatically change the therapeutic outlook in these patients.

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Percutaneous Deep Venous Arterialization for Severe Critical Limb Ischemia in Patients With No Option of Revascularization: Early Experience From Two European Centers

Abstract: pDVA is a safe and feasible vascularization alternative in patients with end-stage/no-option CLI. The early experience highlights the need for a multidisciplinary approach including a dedicated wound care service.

Cited by 39 publications

References 12 publications

Percutaneous Deep Foot Vein Arterialization IVUS-Guided in No-Option Critical Limb Ischemia Diabetic Patients

Percutaneous Deep Foot Vein Arterialization IVUS-Guided in No-Option Critical Limb Ischemia Diabetic Patients

Current Trends in Critical Limb Ischemia - Review

Current review with evolving management strategies in critical limb ischemia

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