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Open Superficial Venous Arterialization for Limb Salvage
Kayden Chahal1, Agilandiswari Arumuga Jothi1, Ahmed Helal1
1Mid and South Essex Vascular Unit, Basildon Hospital, Basildon, Essex, UK.
Annals of Vascular Surgery
|August 18, 2025
Summary
Superficial venous arterialisation (SVA) offers limb salvage for chronic limb-threatening ischemia (CLTI) patients. This study reports the longest follow-up, showing a 40% limb salvage rate and technical success in 80% of cases.
Area of Science:
- Vascular Surgery
- Limb Salvage Procedures
Background:
- Chronic limb-threatening ischemia (CLTI) often leads to amputation when conventional treatments fail.
- Superficial venous arterialisation (SVA) is an alternative revascularisation strategy.
- Limited long-term success data exists for SVA.
Purpose of the Study:
- To evaluate the efficacy and outcomes of Superficial venous arterialisation (SVA) for limb salvage in CLTI patients.
- To report the longest follow-up data for SVA.
- To identify factors influencing SVA success and failure.
Main Methods:
- Retrospective review of five patients undergoing open lower limb SVA (Lengua technique) between 2019-2023.
- Primary endpoint: limb salvage.
- Clinical and duplex ultrasound follow-up, with a median of 5 months (range 1-36 months).
Main Results:
- 80% technical success rate.
- 40% limb salvage rate achieved; rest pain resolved and wounds healed in successful cases.
- Longest follow-up reported at 3 years; 3 patients ultimately required amputation.
Conclusions:
- SVA is a viable, albeit unconventional, option for limb salvage in select CLTI patients.
- Younger, fitter patients may benefit most from SVA.
- Understanding technical considerations, anatomy, and failure reasons is crucial for SVA outcomes.
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