Foot venous system arterialization for salvage of nonreconstructable acute ischemic limb: A case report

Keshelava, Grigol; Gigilashvili, Kakhaber; Chkholaria, Alexandre; Pagava, Gocha; Janashia, Giorgi; Beselia, Kakha

doi:10.1016/j.jvn.2008.10.002

Cited by 5 publications

(13 citation statements)

References 12 publications

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“…The Duplex ultrasound (DUS) study was the most frequently reported follow-up method followed by TCPo 2 and angiography. 6,[8][9][10][11][12][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] Other methods infrequently used included ankle-brachial index (ABI), toebrachial index (TBI), toe pressure (TP), computed tomography (CT) angiography, and scintillography. 10,23 Duplex Ultrasound Some authors obtained DUS as early as 7 days postoperatively while one obtained the first DUS at week 6.…”

Section: Resultsmentioning

confidence: 99%

A Review of Current Noninvasive Imaging Surveillance Practices for Deep Venous Arterialization Procedures

Yan

Treffalls

Ferrer

2021

Journal for Vascular Ultrasound

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Venous arterialization is an increasingly common procedure performed in patients with critical limb-threatening ischemia (CLTI) where there are no open or percutaneous revascularization options. This study aims to review the imaging follow-up for venous arterialization described in the literature. A systematic review was performed on venous arterialization studies for CLTI using the PRISMA methodology. A literature search was performed on 5 databases from inception. We included all original studies, case reports, and reviews regarding venous arterialization for all pathologies. We excluded free standing abstracts, animal studies, other than lower extremity, and foreign language studies. Our search strategy yielded 23 studies that met inclusion criteria, with 16 studies reporting a specific value from at least one surveillance imaging methodology. Most studies used Duplex imaging (16 studies) and TCPo2 (9 studies). Only 9 studies provided any detail regarding the Duplex findings. One study used focal peak systolic velocity (PSV) gradient (PSV at the lesion in the graft divided by PSV in a proximal segment of the graft) above 2.5 as an indicator for flow-inhibiting venous valves or stenosis in the graft. Another study reported a turbulent flow pattern in the graft, elevating peak velocities to 100 to 200 cm/s throughout the bypass. Four studies reported flow volume measurement through the bypass or in pedal vein ranging from 40 to 437 mL/min. Seven studies reported a mean increase of 18.7 mmHg in TCPo2. Eighty-two percent of patients saw an improvement of TCPo2 in 2 studies. To date, no criteria have been identified that are predictive of the success or failure of deep vein arterialization. Venous arterialization is an increasingly common procedure in the “no-option” diabetic patient. Duplex imaging with TCPo2 offers the most appropriate means of surveillance; however, the literature is sparse with no guidance on normal or critical values.

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Section: Resultsmentioning

confidence: 99%

A Review of Current Noninvasive Imaging Surveillance Practices for Deep Venous Arterialization Procedures

Yan

Treffalls

Ferrer

2021

Journal for Vascular Ultrasound

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“…Other clinical signs were also assessed, such as increased limb temperature, limb color, and perfusion time. 4 , 9 …”

Section: Methodsmentioning

confidence: 99%

“… 1 , 5 Graft patency should be verified in the immediate postoperative period, in addition to checking limb temperature and reduction of pain. 4 , 9 …”

Section: Introductionmentioning

confidence: 99%

“…As primeiras tentativas de arterialização do arco venoso do pé foram descritas em 1970 por Lengua, ao tentar levar sangue arterial através do sistema venoso por via retrógrada, com o intuito de melhorar a perfusão periférica e promover a cicatrização de lesões 1 - 8 . Essa técnica promove a reversão do fluxo nos capilares, melhorando a nutrição tecidual, aumentando o fluxo nas colaterais existentes e estimulando a angiogênese 2 , 3 , 5 , 6 , 8 , 9 . Ela está indicada em casos de isquemia crítica ameaçadora de membros 4 , 5 sem leito distal adequado que possibilite tratamento convencional com a finalidade de salvamento do membro 1 , 3 , 4 .…”

Section: Introductionunclassified

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Superficial venous arterialization with the great saphenous vein in situ: a single-center experience

Silva,

Manhanelli Filho,

Morad

et al. 2024

J. vasc. bras.

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Background Arterialization of the dorsal venous arch of the foot is a technique indicated in cases of critical lower limb ischemia that do not have a distal bed that is adequate to enable conventional treatment such as revascularization, angioplasty, or clinical treatment. Objectives The purpose of this study is to present the result of arterialization of the venous arch of the foot in 16 patients who underwent treatment with this technique. Methods This is a cross-sectional retrospective descriptive analytical study based on a review of the medical records of 16 patients who underwent arterialization of the dorsal venous arch of the foot for limb salvage from January 2016 to January 2021. Results Four (25%) of the 16 patients who underwent arterialization of the venous arch of the foot underwent a major amputation during the same hospital stay and one patient (6.25%) had a major amputation within 6 months. The other 11 patients (68.75%) had their limbs preserved, with 10 undergoing minor amputations (toes and forefoot) and one patient having no additional procedures. Conclusions We conclude that the technique of arterialization of the dorsal venous arch of the foot should be considered in selected cases. It is a valid alternative for limb salvage when conventional treatment is impossible.

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“…Realizadas na parte proximal dos membros inferiores, não obtiveram resultados favoráveis. A partir da década de 1970, com os trabalhos pioneiros de Lengua 1 , as fístulas passaram a ser estendidas até o pé, e os bons resultados apareceram em várias publicações, utilizando-se a veia safena magna reversa [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] e in situ 11,[17][18][19][20] .…”

Section: Introductionunclassified

Utilização da safena magna in situ para arterialização do arco venoso do pé

Busato

Utrabo

Gomes³

et al. 2010

J. vasc. bras.

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CONTEXTO: O tratamento da isquemia crítica de membros inferiores sem leito arterial distal pode ser realizado por meio da inversão do fluxo no arco venoso do pé. OBJETIVO: O objetivo deste trabalho foi apresentar a técnica e os resultados obtidos com a arterialização do arco venoso do pé, mantendo a safena magna in situ. MÉTODOS: Dezoito pacientes, dos quais 11 com aterosclerose (AO), 6 com tromboangeíte obliterante (TO) e 1 com trombose de aneurisma de artéria poplítea (TA) foram submetidos ao método. A safena magna in situ foi anastomosada à melhor artéria doadora. O fluxo arterial derivado para o sistema venoso progride por meio da veia cujas válvulas são destruídas. As colaterais da veia safena magna são ligadas desde a anastomose até o maléolo medial, a partir do qual são preservadas. RESULTADOS: Dos pacientes, 10 (55,6%) mantiveram suas extremidades, 5 com AO e 5 com TO; 7 (38,9%) foram amputados, 5 com AO, 1 com TO e 1 com Ta; houve 1 óbito (5,5%). CONCLUSÃO: A inversão do fluxo arterial no sistema venoso do pé deve ser considerada para salvamento de extremidade com isquemia crítica sem leito arterial distal.

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Foot venous system arterialization for salvage of nonreconstructable acute ischemic limb: A case report

Cited by 5 publications

References 12 publications

A Review of Current Noninvasive Imaging Surveillance Practices for Deep Venous Arterialization Procedures

A Review of Current Noninvasive Imaging Surveillance Practices for Deep Venous Arterialization Procedures

Superficial venous arterialization with the great saphenous vein in situ: a single-center experience

Utilização da safena magna in situ para arterialização do arco venoso do pé

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