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Venous Arterialization-Based Extracorporeal Perfusion for Chronic Limb-Threatening Ischemia: A Retrospective

Lei Gao1, Xinyuan Qin1, Tianbo Li1

  • 1Orthopedic Department, Capital Medical University Affiliated Beijing Shijitan Hospital, No. 10 Yangfangdian Tieyi Road, Haidian District, Beijing 100038, China.

Journal of Clinical Medicine
|December 30, 2025
PubMed

Insights

This study shows that venous arterialization-based extracorporeal perfusion significantly improves circulation and healing in chronic limb-threatening ischemia (CLTI) patients. The technique enhances limb salvage rates for those ineligible for traditional treatments.

Area of Science:

  • Vascular Surgery
  • Regenerative Medicine
  • Medical Devices

Background:

  • Chronic limb-threatening ischemia (CLTI) is the severe stage of peripheral arterial disease, often leading to limb loss.
  • Patients unsuitable for conventional revascularization require novel therapeutic strategies.
  • Venous arterialization-based extracorporeal perfusion is an emerging technique for CLTI management.

Purpose of the Study:

  • To evaluate the clinical efficacy of venous arterialization-based extracorporeal perfusion in CLTI patients.
  • To assess improvements in microcirculation and clinical symptoms.
  • To determine the impact on limb salvage rates.

Main Methods:

  • A retrospective, single-center, non-randomized comparative cohort study of 76 CLTI patients.
  • Patients were divided into a perfusion group (n=38) and a control group (n=38).
  • The perfusion group received daily extracorporeal perfusion for 7 days; efficacy assessed via ABI, TcPO2, skin temperature, wound area, and VAS scores.

Main Results:

  • The perfusion group showed significant improvements in ABI, TcPO2, and skin temperature compared to controls (p < 0.001).
  • Higher wound healing rates at 7 days (23.16% vs. 5.62%, p < 0.001) and improved VAS scores were observed.
  • The 6-month limb salvage rate was significantly higher in the perfusion group (86.8% vs. 26.3%, p < 0.001).

Conclusions:

  • Venous arterialization-based extracorporeal perfusion effectively enhances microcirculation and clinical outcomes in CLTI patients.
  • This technique demonstrates potential as an adjunctive therapy for improving limb salvage.
  • Further research may validate its role in managing severe peripheral arterial disease.

Keywords:
Visual Analogue Scaleankle-brachial indexchronic limb-threatening ischemiaextracorporeal perfusionlimb salvagetranscutaneous oxygen pressurevenous arterializationwound healing

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