Related Experiment Video

Updated: May 6, 2026

High-Resolution Three-Dimensional Imaging of the Footpad Vasculature in a Murine Hindlimb Gangrene Model
08:16

High-Resolution Three-Dimensional Imaging of the Footpad Vasculature in a Murine Hindlimb Gangrene Model

Published on: March 16, 2022

3.1K

Comparative study of venous arterialization and pedal bypass in a patient cohort with critical limb ischemia

Michiel A Schreve1, Robert C Minnee1, Jan Bosma1

  • 1Department of Vascular Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.

Annals of Vascular Surgery
|November 6, 2013
PubMed

Insights

Distal venous arterialization and pedal bypass surgery show similar limb salvage rates for critical limb ischemia (CLI) patients. Bypass occlusion is the main risk factor for amputation, highlighting the need for effective graft monitoring.

Area of Science:

  • Vascular Surgery
  • Reconstructive Surgery
  • Clinical Outcomes Research

Background:

  • Critical limb ischemia (CLI) significantly impacts patient life expectancy and independence.
  • Revascularization is crucial for limb salvage in CLI patients.
  • Identifying risk factors for graft failure and amputation is vital.

Purpose of the Study:

  • To compare the clinical outcomes of distal venous arterialization versus pedal bypass surgery in CLI patients.
  • To identify risk factors associated with graft occlusion and amputation in CLI treatment.

Main Methods:

  • Retrospective cohort study of 40 CLI patients treated between 2007 and 2012.
  • Comparison of venous arterialization (n=21) and pedal bypass (n=19) outcomes.
  • Kaplan-Meier and Cox regression analyses for limb salvage and patency predictors.

Main Results:

  • Venous arterialization: 15% early occlusion, 71% 1-year patency, 53% limb salvage.
  • Pedal bypass: 23% early occlusion, 75% 1-year patency, 47% limb salvage.
  • Bypass occlusion was the sole independent risk factor for limb salvage (P<0.001).

Conclusions:

  • Distal venous arterialization offers comparable limb salvage rates to pedal bypass surgery in CLI patients.
  • Graft occlusion is a critical determinant of limb salvage success.
  • Further research may refine patient selection and risk factor management for CLI revascularization.
Abstract

More Related Videos

Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia07:25

Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia

Published on: September 22, 2020

2.8K
Vein Interposition Model: A Suitable Model to Study Bypass Graft Patency07:22

Vein Interposition Model: A Suitable Model to Study Bypass Graft Patency

Published on: January 15, 2017

8.2K

Related Concept Videos

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
773
Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
637
Assessment of the Cardiovascular System III: Palpation01:27

Assessment of the Cardiovascular System III: Palpation

Palpation involves feeling the body to evaluate texture, size, consistency, and tenderness for assessing cardiovascular health. The following steps are organized in a head-to-toe order:
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
1.6K
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
659
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies01:20

Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies

The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
470
Varicose Veins II: Diagnostic Studies and Interprofessional Care01:26

Varicose Veins II: Diagnostic Studies and Interprofessional Care

Varicose veins, or varicosities, develop when the valves in the veins, which control blood flow, weaken or damage. It causes blood to pool and the veins to enlarge. Understanding the clinical manifestations, diagnostic approaches, and management options for varicose veins is crucial for effective treatment and relief.Clinical manifestationsClinical manifestations of varicose veins include a heavy, achy feeling or pain after prolonged standing or sitting. This discomfort can often be relieved by...
326