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Role of Percutaneous Deep Venous Arterialization for Patients with Chronic Limb-threatening Ischemia
Shigeo Ichihashi1, Shinichi Iwakoshi1, Takahiro Nakai1
1Department of Diagnostic and Interventional Radiology, Nara Medical University, Japan.
Abstract:
Efficacy of percutaneous deep venous arterialization (pDVA) has been reported for patients with no-option chronic limb-threatening ischemia (CLTI). In the countries where a manufactured device dedicated for pDVA has not been reimbursed, pDVA using the off-the-shelf technique has alternatively spread. The off-the-shelf techniques for arteriovenous fistula (AVF) creation reported are as follows: AV spear technique, venous arterialization simplified technique (VAST), and a use of penetration guidewire or a reentry device. Technical success rates of the procedures are similar to those using the dedicated device. pDVA could be a last resort for the patients with no-option CLTI, including those suffering from stump ulcer after major limb amputation or those with occluded surgical bypass.
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