Short-Term Outcomes and Efficacy of Percutaneous Deep Vein Arterialization for No-Option Critical Limb Ischemia: A Systematic Review and Meta-Analysis
These videos have been matched automatically. Contact us if they are not relevant.
These videos have been matched automatically. Contact us if they are not relevant.
View abstract on PubMed
Summary
This summary is machine-generated.Percutaneous deep vein arterialization (pDVA) is a feasible option for critical limb ischemia patients. While showing promise for limb salvage and survival, further research is needed due to limited evidence.
Area Of Science
- Vascular Surgery
- Interventional Cardiology
- Regenerative Medicine
Background
- Critical Limb Ischemia (CLI) poses a significant challenge, particularly for patients lacking standard revascularization options.
- Percutaneous deep vein arterialization (pDVA) has emerged as a potential limb salvage strategy in these 'no-option' patients.
- However, robust evidence on the safety and efficacy of pDVA remains limited.
Purpose Of The Study
- To systematically review and meta-analyze the existing literature on percutaneous deep vein arterialization (pDVA) for critical limb ischemia.
- To evaluate the technical success, survival, and limb salvage rates associated with pDVA.
- To assess secondary outcomes including wound healing and reintervention rates.
Main Methods
- A comprehensive literature search was conducted across MEDLINE, Embase, Web of Science, and the CENTRAL registry up to June 2023.
- The review followed PRISMA guidelines, with risk of bias assessed using the Methodological Index for Non-Randomized Studies (MINORS).
- Primary endpoints included technical success, overall survival, and limb salvage; secondary outcomes comprised amputation-free survival, wound healing, and adverse limb events.
Main Results
- Five observational studies with 208 patients (Rutherford class 5/6) were included, showing a low risk of bias.
- Pooled technical success was high (96.2%), with overall survival at 82.8% and limb salvage at 77.2%.
- Amputation-free survival rates were 87.8% (30 days), 68.7% (6 months), and 65.6% (1 year), with a 53.4% complete wound healing rate and a high reintervention rate (46.7%).
Conclusions
- Percutaneous deep vein arterialization (pDVA) appears to be a viable 'bail-out' treatment for patients with no other options for critical limb ischemia.
- Despite promising outcomes in limb salvage and survival, the current evidence strength is low due to the limited number of included studies.
- Further high-quality research is warranted to solidify the role of pDVA in managing CLI.
These videos have been matched automatically. Contact us if they are not relevant.
These videos have been matched automatically. Contact us if they are not relevant.
