Percutaneous deep venous arterialization in patients with critical limb ischemia

Kum, Steven; Huizing, Eline; Schreve, Michiel A; Ünlü, Çağdaş; Ferraresi, Roberto; Samarakoon, Lasitha; Heuvel, Daniel A. van den

doi:10.23736/s0021-9509.18.10569-6

Cited by 28 publications

(25 citation statements)

References 13 publications

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“…Pre-arterial cells that give rise to coronary arteries are too few in number with no previously known markers to be found in conventional analyses. This novel mechanism of venous-to-arterial phenotype transition also provides insights needed to optimize vascular interventions that induce the same transition, including arteriovenous fistulas in hemodialysis patients (78,79), deep vein arterialization in claudicated limb ischemia patients (80,81) and autologous vessel grafts in coronary bypass surgery patients (82).…”

Section: Cardiac Vascular Differentiationmentioning

confidence: 97%

Single Cell Analysis in Vascular Biology

Chavkin

Hirschi

2020

Front. Cardiovasc. Med.

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The ability to quantify DNA, RNA, and protein variations at the single cell level has revolutionized our understanding of cellular heterogeneity within tissues. Via such analyses, individual cells within populations previously thought to be homogeneous can now be delineated into specific subpopulations expressing unique sets of genes, enabling specialized functions. In vascular biology, studies using single cell RNA sequencing have revealed extensive heterogeneity among endothelial and mural cells even within the same vessel, key intermediate cell types that arise during blood and lymphatic vessel development, and cell-type specific responses to disease. Thus, emerging new single cell analysis techniques are enabling vascular biologists to elucidate mechanisms of vascular development, homeostasis, and disease that were previously not possible. In this review, we will provide an overview of single cell analysis methods and highlight recent advances in vascular biology made possible through single cell RNA sequencing.

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Section: Cardiac Vascular Differentiationmentioning

confidence: 97%

Single Cell Analysis in Vascular Biology

Chavkin

Hirschi

2020

Front. Cardiovasc. Med.

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“…The procedure was performed using the LimFlow device, as described in detail previously [ 4 , 7 ]. In brief, antegrade arterial access and distal venous access were achieved by ultrasound-guided puncture of the femoral artery and target tibial vein at the ankle, respectively.…”

Section: Methodsmentioning

confidence: 99%

“…In this procedure, a connection is made between a tibial artery and a tibial vein creating an arteriovenous (AF) fistula, after which the valves in the vein are destroyed, and the side branches are covered with a covered stent to provide pressurized arterial flow to the venous system of the foot. We call this the arteriovenous (AV) circuit [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Volume Flow and Peak Systolic Velocity of the Arteriovenous Circuit in Patients after Percutaneous Deep Venous Arterialization

Schreve¹,

Huizing²,

Kum

et al. 2020

Diagnostics

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Percutaneous deep venous arterialization (pDVA) is a developing technique for limb salvage in patients with chronic limb-threatening ischemia by creating an arteriovenous (AV) circuit. After pDVA, patency of the AV circuit is evaluated using duplex ultrasound (DUS) imaging. Peak systolic velocity (PSV) and volume flow (VF) values for maintaining a patent AV circuit are undefined; therefore, guidance about when a reintervention should be performed is lacking. The objective of this study was to interpret post-pDVA PSV and VF values in relation to AV circuit preservation. This was performed by analyzing DUS results of 22 post-pDVA patients. A total of 670 PSV and 623 VF measurements were collected. A PSV value of ≤55 cm/s and a VF value of ≤195 mL/min were found predictive for failure. The reliability of PSV and VF measurements in patent AV-circuits was good (intraclass correlation coefficient; PSV, 0.85; VF, 0.88). In conclusion, this study is the first to analyze DUS measurements in post-pDVA patients and showed that DUS can be used to anticipate for failure. The thresholds found can be used to help interpret DUS measurements in post-pDVA patients. More research in a larger patient population is needed to prospectively validate these thresholds.

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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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Percutaneous deep venous arterialization in patients with critical limb ischemia

Abstract: The LimFlow system is currently the only registered device a total percutaneous DVA can be performed with. In addition to the percutaneous creation of an arteriovenous fistula (AVF), it also allows disruption of the veins with a dedicated valvulotome.

Cited by 28 publications

References 13 publications

Single Cell Analysis in Vascular Biology

Single Cell Analysis in Vascular Biology

Volume Flow and Peak Systolic Velocity of the Arteriovenous Circuit in Patients after Percutaneous Deep Venous Arterialization

Current Trends in Critical Limb Ischemia - Review

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