Arterialization of the Distal Venous System Alone or Combined With Bypasses to Limited Outflow Tracts: A Last Resort for the "Unsalvageable Leg"?

Ascer, Enrico; Veith, Frank J.

doi:10.1177/153100359300600109

Cited by 4 publications

(4 citation statements)

References 6 publications

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“…To attain optimal results, variauons of fistula location and configuration have been devised. [1][2][3][4] The advocates of these various patterns offistula construction have all shown enhanced patency and limb salvage rates, although prospective randomized studies have to date not been performed. Out group has had extensive experience with the common ostium method, and this experience has resulted in a series of technical modifications that have had a positive impact on early graft patency and limb salvage rates.…”

Section: Discussionmentioning

confidence: 99%

Improved method to create the common ostium variant of the distal arteriovenous fistula for enhancing crural prosthetic graft patency

Dardik¹,

Silvestri²,

Alasio³

et al. 1996

Journal of Vascular Surgery

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Configuration of the adjunctive dAVF may impact on prosthetic graft patency in the crural position. In addition, the type of graft material used for bypass may be instrumental in preventing or precipitating the steal phenomenon. These issues require further study to better understand flow dynamics, patterns of intimal hyperplasia, and blood distribution as a function of conduit material and impedance of the arterial and venous runoff.

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Section: Discussionmentioning

confidence: 99%

Improved method to create the common ostium variant of the distal arteriovenous fistula for enhancing crural prosthetic graft patency

Dardik¹,

Silvestri²,

Alasio³

et al. 1996

Journal of Vascular Surgery

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“…Before the advent of direct arterial bypass, fistulas were constructed to create flow reversal in the venous circulation and carry arterial blood to the capillary bed in a retrograde fashion. 10,11 With the advance of standard bypass techniques, direct revascularization of the arterial tree became a more effective method than retrograde venous flow reversal to alleviate ischemia in the lower extremity. AVFs were then proposed as a method to decrease outflow resistance and improve prosthetic graft performance.…”

Section: Discussionmentioning

confidence: 99%

Distal vein patch with an arteriovenous fistula: A viable option for the patient without autogenous conduit and severe distal occlusive disease

Neville

Singh

et al. 2009

Journal of Vascular Surgery

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This early experience describes a modification of the DVP technique in patients with threatened limb loss and severely disadvantaged tibial runoff. The addition of an AVF may reduce outflow resistance, thereby contributing to higher flow rates and improved graft patency. Further investigation is warranted because the DVP-AVF technique may result in acceptable graft patency and limb salvage for patients with no other alternative than amputation.

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“…Despite these apparently positive results, the procedure has never gained wide acceptance, essentially due to the complexity of the technique, the conflicting results, and the lack of clear technical standardization. 10 This report describes our preliminary experience in treating no-option CLI patients with a hybrid foot vein Journal of Endovascular Therapy 26 (1) arterialization (HFVA) technique combining open and endovascular approaches.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Hybrid Foot Vein Arterialization in No-Option Patients With Critical Limb Ischemia: A Preliminary Report

et al. 2018

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To describe a preliminary experience in treating no-option critical limb ischemia (CLI) patients with a hybrid foot vein arterialization (HFVA) technique combining open plus endovascular approaches. Materials and Methods: Between May 2016 and January 2018, 35 consecutive patients (mean age 68±12 years; 28 men) with 36 no-option CLI limbs underwent HFVA in our center. All limbs had grade 3 WIfI (Wound, Ischemia, and foot Infection) ischemia, and the wound classification was grade 1 in 4 (11%) limbs, grade 2 in 4 (11%), and grade 3 in 28 (78%). Surgical bypass was done on the medial marginal vein or a posterior tibial vein, followed by endovascular removal of foot vein valves and embolization of foot vein collaterals. A "tension-free" surgical approach was used to treat foot lesions. Results: At a mean follow-up of 10.8±2 months, limb salvage was achieved in 25 (69%) limbs and wound healing in 16 (44%); 9 patients presented an unhealed wound. Eleven (31%) patients underwent a major amputation (2 below the knee and 9 thigh). One patient with an unhealed wound and open bypass died of myocardial infarction. Conclusion: HFVA is a promising technique able to achieve acceptable rates of limb salvage and wound healing in no-option patients generally considered candidates for an impending major amputation. Further studies are needed to standardize the technique and better identify patients who can benefit from this approach.

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Arterialization of the Distal Venous System Alone or Combined With Bypasses to Limited Outflow Tracts: A Last Resort for the "Unsalvageable Leg"?

Cited by 4 publications

References 6 publications

Improved method to create the common ostium variant of the distal arteriovenous fistula for enhancing crural prosthetic graft patency

Improved method to create the common ostium variant of the distal arteriovenous fistula for enhancing crural prosthetic graft patency

Distal vein patch with an arteriovenous fistula: A viable option for the patient without autogenous conduit and severe distal occlusive disease

Hybrid Foot Vein Arterialization in No-Option Patients With Critical Limb Ischemia: A Preliminary Report

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