Initial experience with dorsal venous arch arterialization for limb salvage.
Surgical reconstruction for patients with symptomatic lower extremity arterial occlusive disease is successful when a suitable distal target vessel is present. In patients with unreconstructable disease, practical surgical options are at a minimum. We report our initial experience with dorsal venous arch arterialization (DVAA) for limb salvage. Patients with a lower extremity arteriogram and tibia/plantar artery duplex scan demonstrating unreconstructable occlusive disease were evaluated for DVAA. The venous arch valve lysis technique consisted of retrograde balloon catheter, arterial dilator disruption, and direct valvulectomy. Outcome variables included patency, limb salvage rate, and toe pressure alterations. Initial results suggest that DVAA may be a viable option for end-stage limb salvage. Application of the DVAA appears to be more suitable for patients with symptoms secondary to atherosclerosis than those with Buerger's disease.
Rowe
Vincent L
VL
Department of Surgery, Division of Vascular Surgery, LAC+USC Medical Center, Keck School of Medicine at the University of Southern California, Los Angeles, CA 90033, USA. vrowe@surgery.usc.edu
Hood
Douglas B
DB
Lipham
John
J
Terramani
Tom
T
Torres
Gustavo
G
Katz
Steve
S
Kohl
Roy
R
Weaver
Fred A
FA
D000328:Adult; D000714:Anastomosis, Surgical; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000601:surgery*; D005500:Follow-Up Studies; D005528:Foot / Q000098:blood supply*; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000601:surgery; D023821:Limb Salvage / Q000379:methods*; D008875:Middle Aged; D012501:Saphenous Vein / Q000601:surgery*; D018616:Ultrasonography, Doppler, Duplex