Deep Venous Arterialization for Limb Salvage

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Ho VT, Gologorsky R, Kibrik P, et al. Open, percutaneous, and hybrid deep venous arterialization technique for no-option foot salvage. J Vasc Surg. 2020. https://doi.org/10.1016/j.jvs.2019.10.085.

Clair D, Gibbons M. A review of percutaneous deep vein arterialization for the treatment of nonreconstructable chronic limb threatening ischemia. Semin Vasc Surg. 2021. https://doi.org/10.1053/j.semvascsurg.2021.10.006.

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Schreve MA, Unlu C, Kum S, et al. Surgical and endovascular venous arterialization: ready to take the “desert” by storm? J Cardiovasc Surg (Torino). 2017. https://doi.org/10.23736/S0021-9509.17.09844-5.

•Lengua F, Nuss JM, Buffet JM, et al. [Comparative study of two methods of arterialization of foot veins in ischemic crisis]. J Chir (Paris). 1993; 12–9. Early study examining outcomes of venous arterialization demonstrating decrease in amputation rate, pain relief, and improvements in healing and ambulatory function

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• Engelke C, Morgan RA, Quarmby JW, et al. Distal venous arterialization for lower limb salvage: angiographic appearances and interventional procedures. 2001. https://doi.org/10.1148/radiographics.21.5.g01se281239. Study examining 18 patients who underwent venous arterialization after angiography demonstrated absence of suitable arterial vessels for revascularization, with improvements in limb salvage rates

• Ozbek C, Kestelli M, Emrecan B, et al. A novel approach: ascending venous arterialization for atherosclerosis obliterans. Eur J Vasc Endovasc Surg. 2005; 47–51. https://doi.org/10.1016/j.ejvs.2004.09.027. Study examining a novel approach to venous arterialization involving reversed saphenous vein grafts allowing flow from femoral or popliteal arteries to native saphenous vein at the ankle

• Migliara B, Cappellari TF, Mirandola M, et al. Percutaneous saphenous vein arterialization. J Endovasc Ther. 2021; 823–7. https://doi.org/10.1177/15266028211030530. First study describing completely percutaneous arterialization of the venous system of the foot

• Gandini R, Merolla S, Scaggiante J, et al. Endovascular distal plantar vein arterialization in dialysis patients with no-option critical limb ischemia and posterior tibial artery occlusion: a technique for limb salvage in a challenging patient subset. J Endovasc Ther. 2018; 127–32. https://doi.org/10.1177/1526602817750211. Study describing a technique for percutaneous arterialization of the distal plantar veins in patients with diabetes, end stage renal disease, and no-option critical limb ischemia

• Ferraresi R, Casini A, Losurdo F, et al. Hybrid foot vein arterialization in no-option patients with critical limb ischemia: a preliminary report. J Endovasc Ther. 2019; 7–17. https://doi.org/10.1177/1526602818820792. Study describing a hybrid approach to venous arterialization combining both surgical and endovascular techniques

• Alexandrescu V, Ngongang C, Vincent G, et al. Deep calf veins arterialization for inferior limb preservation in diabetic patients with extended ischaemic wounds, unfit for direct arterial reconstruction: preliminary results according to an angiosome model of perfusion. Cardiovasc Revasc Med. 2011; 10–9. https://doi.org/10.1016/j.carrev.2009.12.002. Study examining outcomes following angiosome-directed hybrid DVA, demonstrating 73% limb salvage rate

N’Dandu Z, Bonilla J, Yousef GM, et al. Percutaneous deep vein arterialization: an emerging technique for no-option chronic limb-threatening ischemia patients. Catheter Cardiovasc Interv. 2021. https://doi.org/10.1002/ccd.29386.

• Zaman NS, Shackles C, Moriarty KT, et al. Patterns of failure in deep venous arterialization and implications for management. J Crit Limb Ischemia. 2022. Case series examining types of failure following DVA, in addition to reintervention requirements

Nakama T, Obunai K, Kojima S, et al. Angiographic findings of the development of a reverse blood supply after percutaneous deep venous arterialization. JACC Cardiovasc Interv. 2020. https://doi.org/10.1016/j.jcin.2020.01.225.

Harfouch T, Tarus A, Agafitei ET, et al. Combined superficial and deep venous arterialization in no-option critical limb ischemia: case report. Vasc Endovasc Surg. 2021. https://doi.org/10.1177/1538574421989861.

• Beland M, Methot M, Bradette S, et al. Venous arterialization with common endovascular devices. J Vasc Interv Radiol. 2019; 570–1. https://doi.org/10.1016/j.jvir.2018.11.022. Case report describing successful DVA utilizing commonly available endovascular devices

• Ichihashi S, Shimohara Y, Bolstad F, et al. Simplified endovascular deep venous arterialization for non-option CLI patients by percutaneous direct needle puncture of tibial artery and vein under ultrasound guidance (AV Spear Technique). Cardiovasc Intervent Radiol. 2020; 339–43. https://doi.org/10.1007/s00270-019-02388-2. Case report describing the AV spear technique to achieve percutaneous DVA

• Lechareas S, Sritharan K,Williams RGM. Early and eighteen month clinical outcomes of first UK case of percutaneous deep vein arterialisation (pDVA) to treat "no option" chronic limb-threatening ischemia using the LimFlow system. CVIR Endovasc. 2021; 62. https://doi.org/10.1186/s42155-021-00252-4. Case report describing outcomes to 18 months following use of the dedicated LimFlow system for DVA

• Ichihashi S, Tamura Y, Maeda S, et al. Percutaneous deep venous arterialization at femoropopliteal segment for unhealed amputated stump ulcer after below the knee amputation. Catheter Cardiovasc Interv. 2021; E124-E6. https://doi.org/10.1002/ccd.29693. Case report describing the use of DVA for management of nonhealing stump ulcer following BKA

Chang HW, Hsu CH, Jhang YC, et al. Percutaneous deep vein arterialization for a chronic limb-threatening ischemia patient in Taiwan. Acta Cardiol Sin. 2021. https://doi.org/10.6515/ACS.202107_37(4).20210310A.

Pua U, Huang IKH. Percutaneous deep vein arterialization. J Vasc Interv Radiol. 2019. https://doi.org/10.1016/j.jvir.2018.07.024.

Hines EM, Choy KT, Bhutia S. Deep venous arterialization for no-option critical limb-threatening ischaemia. ANZ J Surg. 2021. https://doi.org/10.1111/ans.16116.

Keshelava G, Gigilashvili K, Chkholaria A, et al. Foot venous system arterialization for salvage of nonreconstructable acute ischemic limb: a case report. J Vasc Nurs. 2009. https://doi.org/10.1016/j.jvn.2008.10.002.

• Clair DG, Mustapha JA, Shishehbor MH, et al. PROMISE I: erly feasibility study of the limflow system for percutaneous deep vein arterialization in no-option chronic limb-threatening ischemia: 12-month results. J Vasc Surg. 2021; 1626–35. https://doi.org/10.1016/j.jvs.2021.04.057. Study reporting 6 and 12 month outcomes following use of LimFlow pDVA system in 32 patients, with findings of improved wound healing and increased amputation-free survival

• Kum S, Tan YK, Schreve MA, et al. Midterm outcomes from a pilot study of percutaneous deep vein arterialization for the treatment of no-option critical limb ischemia. J Endovasc Ther. 2017; 619–26. https://doi.org/10.1177/1526602817719283. Study reporting percutaneous DVA is safe, technically successful, and improves wound healing, pain, and limb salvage

Miranda JA, Pallister Z, Sharath S, et al. Early experience with venous arterialization for limb salvage in no-option patients with chronic limb-threatening ischemia. J Vasc Surg. 2022. https://doi.org/10.1016/j.jvs.2022.05.012.

Del Giudice C, Van Den Heuvel D, Wille J, et al. Percutaneous deep venous arterialization for severe critical limb ischemia in patients with no option of revascularization: early experience from two European centers. Cardiovasc Intervent Radiol. 2018. https://doi.org/10.1007/s00270-018-2020-2.

Schmidt A, Schreve MA, Huizing E, et al. Midterm outcomes of percutaneous deep venous arterialization with a dedicated system for patients with no-option chronic limb-threatening ischemia: the ALPS multicenter study. J Endovasc Ther. 2020. https://doi.org/10.1177/1526602820922179.

Mutirangura P, Ruangsetakit C, Wongwanit C, et al. Pedal bypass with deep venous arterialization: the therapeutic option in critical limb ischemia and unreconstructable distal arteries. Vascular. 2011. https://doi.org/10.1258/vasc.2010.oa0278.

• Nakama T, Ichihashi S, Ogata K, et al. Twelve-month clinical outcomes of percutaneous deep venous arterialization with alternative techniques and ordinary endovascular therapy devices for patients with chronic limb-threatening ischemia: results of the DEPARTURE Japan study. Cardiovasc Intervent Radiol. 2022; 622–32. https://doi.org/10.1007/s00270-022-03095-1. Study of 18 patients who underwent percutaneous DVA demonstrating acceptable limb salvage rates, amputation-free survival rates, and improvements in wound healing

Taylor RS, Belli AM, Jacob S. Distal venous arterialisation for salvage of critically ischaemic inoperable limbs. Lancet. 1999. https://doi.org/10.1016/s0140-6736(99)03164-5.

Kum S, Huizing E, Schreve MA, et al. Percutaneous deep venous arterialization in patients with critical limb ischemia. J Cardiovasc Surg (Torino). 2018. https://doi.org/10.23736/S0021-9509.18.10569-6.

Cangiano G, Corvino F, Giurazza F, et al. Percutaneous deep foot vein arterialization IVUS-guided in no-option critical limb ischemia diabetic patients. Vasc Endovasc Surg. 2021. https://doi.org/10.1177/1538574420965743.

Sultan S, Acharya Y, Hezima M, et al. Hybrid deep venous arterialisation (DVAR) for no-option chronic limb threatening ischemia. Ann Vasc Surg. 2022. https://doi.org/10.1016/j.avsg.2021.07.027.

• Djoric P, Zeleskov-Djoric J, Stanisavljevic DM, et al. Distal venous arterialization and reperfusion injury: focus on oxidative status. Eur Surg Res. 2012; 200–7. https://doi.org/10.1159/000338619. Study examining markers of reperfusion injury following DVA, demonstrating no significant tissue damage and supporting DVA as a safe and efficacious procedure

• Schreve MA, Minnee RC, Bosma J, et al. Comparative study of venous arterialization and pedal bypass in a patient cohort with critical limb ischemia. Ann Vasc Surg. 2014; 1123–7. https://doi.org/10.1016/j.avsg.2013.08.010. Comparative study demonstrating equivalent outcomes of DVA and pedal bypass in patients with critical limb ischemia

Sasajima T, Azuma N, Uchida H, et al. Combined distal venous arterialization and free flap for patients with extensive tissue loss. Ann Vasc Surg. 2010. https://doi.org/10.1016/j.avsg.2009.07.001.

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Lauria AL, Propper BW, Neville RF. Surgical deep vein arterialization: adding to the armamentarium of complex limb salvage. Ann Vasc Surg. 2022. https://doi.org/10.1016/j.avsg.2022.03.036.

• Lu XW, Idu MM, Ubbink DT, et al. Meta-analysis of the clinical effectiveness of venous arterialization for salvage of critically ischaemic limbs. Eur J Vasc Endovasc Surg. 2006; 493–9. https://doi.org/10.1016/j.ejvs.2005.12.017. Meta-analysis of existing studies examining outcomes following DVA, including foot preservation rate of 71% and majority of patients with successful wound healing and improvement of pain

• Schreve MA, Vos CG, Vahl AC, et al. Venous arterialisation for salvage of critically ischaemic limbs: a systematic review and meta-analysis. Eur J Vasc Endovasc Surg. 2017; 387–402. https://doi.org/10.1016/j.ejvs.2016.11.007. Meta-analysis with total 768 patients examining mortality, limb salvage rate (75%), and graft patency at 12 months (59–71%)

• Yan Q, Prasla S, Carlisle DC, et al. Deep venous arterialization for chronic limb threatening ischemia in atherosclerosis patients—a meta-analysis. Ann Vasc Surg. 2022; 1–21. https://doi.org/10.1016/j.avsg.2021.10.059. Meta-analysis of 374 patients who underwent DVA and had 1-year limb salvage rate of 79%

• PROMISE III: Percutaneous deep vein arterialization for the treatment of late-stage chronic limb-threatening ischemia. U.S. National Library of Medicine.2022. https://clinicaltrials.gov/ct2/show/NCT05313165. Accessed 14 Aug 2022. Current clinical trial examining amputation-free survival, graft patency, limb salvage, change in Rutherford classification, and wound healing in patients following use of LimFlow for DVA

• Kim TI, Schneider PA. New Innovations and devices in the management of chronic limb-threatening ischemia. J Endovasc Ther. 2020; 524–39. https://doi.org/10.1177/1526602820921555. Comprehensive review examining new innovative devices and technologies developed for the management of chronic limb-threatening ischemia