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Deep Venous Arterialization for Chronic Limb Threatening Ischemia in Atherosclerosis Patients - A Meta-Analysis

Qi Yan1, Sanaa Prasla2, Daniel C Carlisle2

  • 1Division of Vascular and Endovascular Surgery, University of Texas Health at San Antonio, San Antonio, TX; Department of Surgery, University of Texas Health at San Antonio, San Antonio, TX; South Texas Center for Vascular Care, South Texas Medical Center, San Antonio, TX.

Annals of Vascular Surgery
|December 9, 2021
PubMed

Insights

Venous arterialization offers a viable option for chronic limb-threatening ischemia (CLTI) patients, achieving a 79% limb salvage rate. However, further high-quality studies are necessary to confirm its long-term effectiveness.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Regenerative Medicine

Background:

  • Chronic limb-threatening ischemia (CLTI) presents a significant challenge, especially when standard revascularization is not feasible.
  • Venous arterialization is emerging as a novel alternative treatment for CLTI.
  • This study systematically reviews the outcomes of venous arterialization in CLTI patients.

Purpose of the Study:

  • To systematically review and analyze the outcomes of venous arterialization in patients with CLTI.
  • To assess the effectiveness of venous arterialization as an alternative revascularization strategy.
  • To identify the limb salvage and survival rates associated with venous arterialization.

Main Methods:

  • A systematic literature search was conducted across five databases following PRISMA methodology.
  • Inclusion criteria focused on English original research papers concerning CLTI patients treated with venous arterialization.
  • Meta-analysis was performed using a random-effects model for studies with a sample size of 10 or more.

Main Results:

  • Twelve studies encompassing 442 patients were analyzed, with 374 undergoing venous arterialization.
  • The pooled 1-year limb salvage rate was 79.0% and the 1-year survival rate was 85.7%.
  • Pooled 30-day mortality was 3.7%, morbidity was 15.5%, and major adverse limb events were 16.7%.

Conclusions:

  • Venous arterialization demonstrates an acceptable 1-year limb salvage rate of 79% for CLTI patients.
  • The current evidence is based on a low level of evidence, necessitating further investigation.
  • High-quality randomized controlled trials are required to definitively establish the effectiveness of venous arterialization for CLTI.
Abstract

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