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Initial experience with dorsal venous arch arterialization for limb salvage
Vincent L Rowe1, Douglas B Hood, John Lipham
1Department of Surgery, Division of Vascular Surgery, LAC+USC Medical Center, Keck School of Medicine at the University of Southern California, Los Angeles, CA 90033, USA. vrowe@surgery.usc.edu
Annals of Vascular Surgery
|April 25, 2002
Summary
Dorsal venous arch arterialization (DVAA) offers a new surgical option for limb salvage in patients with unreconstructable lower extremity arterial disease. This technique shows promise for end-stage cases, particularly those caused by atherosclerosis.
Area of Science:
- Vascular Surgery
- Reconstructive Surgery
- Arterial Occlusive Disease
Background:
- Surgical reconstruction for lower extremity arterial occlusive disease relies on suitable distal target vessels.
- Limited surgical options exist for patients with unreconstructable disease, necessitating innovative limb salvage techniques.
Purpose of the Study:
- To evaluate the initial experience and feasibility of dorsal venous arch arterialization (DVAA) as a limb salvage procedure.
- To assess the outcomes of DVAA in patients with end-stage lower extremity arterial occlusive disease.
Main Methods:
- Patients with unreconstructable lower extremity arterial disease underwent DVAA.
- The DVAA technique involved retrograde balloon catheter disruption, arterial dilator disruption, and direct valvulectomy of the venous arch.
- Outcome variables included arterial patency, limb salvage rates, and changes in toe pressure.
Main Results:
- DVAA demonstrated potential as a viable option for limb salvage in end-stage cases.
- The procedure appeared more suitable for patients with atherosclerosis compared to Buerger's disease.
Conclusions:
- Dorsal venous arch arterialization (DVAA) may provide a valuable surgical solution for limb salvage when traditional revascularization is not feasible.
- Further investigation is warranted to establish the long-term efficacy and patient selection criteria for DVAA.