PDF(Pubmed)
Abstract：
UNASSIGNED: Percutaneous deep venous arterialization (pDVA) is a minimally invasive technique connecting the tibial arteries below the knee to the tibial venous system into plantar venous circulation to deliver oxygenated blood to otherwise nonperfused foot. This study demonstrated outcomes of pDVA with commercially available equipment and described single-center experience on pDVA for critical limb-threatening ischemia patients with small artery diseases and end-stage plantar disease (ESPD) who were deemed no-option cases.
UNASSIGNED: A single-center retrospective review was performed on patients who underwent pDVA. Primary end points were successful establishment of tibial vein flow with venous pedal loop, rate of major amputation, and major adverse events over 6 months. Secondary end points were primary and secondary patency rates, minor amputation rates, and wound healing over 6 months.
UNASSIGNED: Forty-two patients with ESPD underwent pDVA. Risk factors identified were hypertension (92.8%), hyperlipidemia (85.7%), diabetes (78.6%), tobacco abuse (42.9%), and chronic kidney disease ≥ stage 3 (42.8%). Three patients were categorized as Rutherford Class 4, 14 patients Class 5, and 25 patients (59.5%) Class 6. Of 42 procedures, 33 (78.6%) were deemed successful. Amputation-free survival at 6 months was reported in 25 patients (60.9%); 16 patients (38.1%) reported minor amputations. Wound healing rate reported at 6 months was 23.8%.
UNASSIGNED: This is one of the largest case series to date with real-world no-option patients undergoing pDVA. pDVA seems a reasonable option for limb salvage in patients with ESPD where traditional arterial revascularization is not feasible. Identifying criteria for patient selection and advanced wound care is important to ensure clinical success. Additional research is required to establish diagnostic guidelines for patients being evaluated for pDVA.
UNASSIGNED: A single-center retrospective review was performed on patients who underwent pDVA. Primary end points were successful establishment of tibial vein flow with venous pedal loop, rate of major amputation, and major adverse events over 6 months. Secondary end points were primary and secondary patency rates, minor amputation rates, and wound healing over 6 months.
UNASSIGNED: Forty-two patients with ESPD underwent pDVA. Risk factors identified were hypertension (92.8%), hyperlipidemia (85.7%), diabetes (78.6%), tobacco abuse (42.9%), and chronic kidney disease ≥ stage 3 (42.8%). Three patients were categorized as Rutherford Class 4, 14 patients Class 5, and 25 patients (59.5%) Class 6. Of 42 procedures, 33 (78.6%) were deemed successful. Amputation-free survival at 6 months was reported in 25 patients (60.9%); 16 patients (38.1%) reported minor amputations. Wound healing rate reported at 6 months was 23.8%.
UNASSIGNED: This is one of the largest case series to date with real-world no-option patients undergoing pDVA. pDVA seems a reasonable option for limb salvage in patients with ESPD where traditional arterial revascularization is not feasible. Identifying criteria for patient selection and advanced wound care is important to ensure clinical success. Additional research is required to establish diagnostic guidelines for patients being evaluated for pDVA.
摘要：
■经皮深静脉动脉化（pDVA）是一种微创技术，将膝盖下方的胫骨动脉连接到胫骨静脉系统进入足底静脉循环，以将含氧血液输送到未灌注的足部。这项研究证明了使用市售设备进行pDVA的结果，并描述了对患有小动脉疾病和终末期足底疾病（ESPD）的严重威胁肢体缺血患者的pDVA的单中心经验。
■对接受pDVA的患者进行了单中心回顾性分析。主要终点为成功建立胫骨静脉血流并使用静脉踏板回路,大截肢率，6个月以上的主要不良事件。次要终点是主要和次要通畅率，轻微的截肢率,伤口愈合超过6个月。
■42例ESPD患者接受了pDVA。确定的危险因素是高血压（92.8％），高脂血症（85.7%），糖尿病（78.6%），烟草滥用(42.9%),慢性肾病≥3期（42.8%）。3名患者被归类为卢瑟福4级，14名患者5级和25名患者（59.5％）6级。在42个程序中，33（78.6％）被认为是成功的。据报道，有25例患者（60.9％）在6个月时无截肢生存；16例患者（38.1％）报告了较小的截肢。6个月时报告的伤口愈合率为23.8%。
■这是迄今为止最大的病例系列之一，真实世界的无选择患者接受pDVA。对于传统的动脉血运重建不可行的ESPD患者，pDVA似乎是保肢的合理选择。确定患者选择和高级伤口护理的标准对于确保临床成功很重要。需要额外的研究来建立pDVA评估患者的诊断指南。
■对接受pDVA的患者进行了单中心回顾性分析。主要终点为成功建立胫骨静脉血流并使用静脉踏板回路,大截肢率，6个月以上的主要不良事件。次要终点是主要和次要通畅率，轻微的截肢率,伤口愈合超过6个月。
■42例ESPD患者接受了pDVA。确定的危险因素是高血压（92.8％），高脂血症（85.7%），糖尿病（78.6%），烟草滥用(42.9%),慢性肾病≥3期（42.8%）。3名患者被归类为卢瑟福4级，14名患者5级和25名患者（59.5％）6级。在42个程序中，33（78.6％）被认为是成功的。据报道，有25例患者（60.9％）在6个月时无截肢生存；16例患者（38.1％）报告了较小的截肢。6个月时报告的伤口愈合率为23.8%。
■这是迄今为止最大的病例系列之一，真实世界的无选择患者接受pDVA。对于传统的动脉血运重建不可行的ESPD患者，pDVA似乎是保肢的合理选择。确定患者选择和高级伤口护理的标准对于确保临床成功很重要。需要额外的研究来建立pDVA评估患者的诊断指南。
