Surgical and endovascular venous arterialization for treatment of critical limb ischaemia

Vasa. 2018 Jan;47(1):17-22. doi: 10.1024/0301-1526/a000669. Epub 2017 Oct 25.

Abstract

Patients with critical limb ischaemia have a poor life expectancy. Aggressive revascularization is accepted in order to preserve their independence in the final phase of their lives. Bypass surgery and more recently endovascular interventions with angioplasty and stenting have become the treatment of choice to prevent amputation and to resolve pain. However, as many as 20 % of patients with critical limb ischaemia are unsuitable candidates for a vascular intervention because of extensive occlusions of outflow in the crural and pedal vessels. Such "no-option critical limb ischaemia" may be treated with venous arterialization. In the present review, we discuss the history of the venous arterialization procedure, the mechanisms, the different techniques, and complications of venous arterialization.

Keywords: Critical limb ischemia; endovascular therapy; venous arterialization; wound management.

Publication types

  • Review

MeSH terms

  • Humans
  • Ischemia / surgery*
  • Limb Salvage*
  • Lower Extremity / blood supply*
  • Peripheral Arterial Disease / surgery*
  • Regional Blood Flow
  • Vascular Patency