Percutaneous approach to deep vein arterialization for the no-option chronic limb-threatening ischemia patient

• 成果类型: Review
• 署名作者: Rice, Jayne R.; Chatman, Brett C.; Genovese, Elizabeth A.
• 署名单位: University of Pennsylvania; Pennsylvania Medicine
• 刊物名称: SEMINARS IN VASCULAR SURGERY
• ISSN/ISSBN: 0895-7967; 1558-4518
• DOI: 10.1053/j.semvascsurg.2025.01.005
• 发表日期: 2025-03
• 页码: 41-53
• 关键词: Venous arterialization; Deep venous arterialization; Peripheral arterial disease; Chronic limb threatening ischemia; No-option CLTI; DISTAL VENOUS ARTERIALIZATION; SALVAGE; foot

摘要

Chronic limb-threatening ischemia is an advanced stage of peripheral artery disease characterized by rest pain or tissue loss. Treatment of patients classified as no-option CLTI remains particularly challenging, as historically their primary treatment has been limited to major amputation. Venous arterialization has emerged as a promising alternative in this difficult-to-treat population. Advances in optimized technology and endovascular techniques, particularly deep venous arterialization, have had encouraging outcomes for longterm limb salvage. Successful limb preservation relies on proper patient selection, a compliant patient, and a robust multidisciplinary clinical team to support the complex processes of deep venous arterialization maturation and wound healing. This review will discuss the historical background of venous arterialization, patient selection criteria, and surgical techniques for percutaneous deep venous arterialization, and postoperative management after the index procedure, including wound care, surveillance, and reintervention strategies for successful limb salvage. (c) 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.