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Percutaneous deep vein arterialization: An emerging technique for no-option chronic limb-threatening ischemia

Zola N'Dandu1, Jonathan Bonilla1, George M Yousef1

  • 1Department of Cardiology, Ochsner Health System, New Orleans, Louisiana, USA.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|November 21, 2020
PubMed

Insights

Percutaneous deep vein arterialization (pDVA) offers a limb salvage option for patients with end-stage Chronic Limb-Threatening Ischemia (CLTI) when traditional methods fail. This case demonstrates successful pDVA in a high-risk patient facing amputation.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Regenerative Medicine

Background:

  • Chronic limb-threatening ischemia (CLTI) is a severe condition often leading to amputation.
  • End-stage CLTI with pedal artery occlusion presents challenges for conventional revascularization.
  • Limb salvage is the primary goal in managing CLTI.

Observation:

  • A patient with no-option CLTI faced imminent major amputation after failed endovascular attempts.
  • The patient had end-stage disease with occluded pedal arteries, lacking suitable targets for bypass.
  • Conventional revascularization strategies were unsuccessful.

Findings:

  • Percutaneous deep vein arterialization (pDVA) was successfully performed as a last resort.
  • The pDVA procedure achieved limb salvage in this high-risk patient.
  • This nontraditional technique provided a viable revascularization option.

Implications:

  • pDVA may be a crucial technique for limb salvage in complex CLTI cases.
  • It offers hope for patients previously deemed untreatable, avoiding amputation.
  • Further research into pDVA can expand treatment options for CLTI.

Keywords:
critical limb threatening ischemiaendovascular interventionperipheral arterial disease

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