Superficial venous arterialization outflow stenting, an alternative to open venous branch ligation

In the last 20 years, the prevalence of peripheral artery disease has increased by 72%, with affected patients facing a 5% to 10% risk at 5 years of developing chronic limb-threatening ischemia. Approximately 20% of patients with limb-threatening ischemia have no revascularization options and may face amputation. Venous arterialization was conceptualized in the early 1900s as a last resort limb salvage strategy. We present four cases of no-option revascularization in which patients underwent a novel technique of superficial venous arterialization using a long stent to cover venous branches to optimize distal arterial perfusion and limit additional wounds, resulting in a 75% limb salvage rate.