Surgical and endovascular venous arterialization: ready to take the "desert" by storm?
Patients with critical limb ischemia have a poor life expectancy, and aggressive revascularization is accepted to maintain their independence in the end stage of life. Bypass surgery and, more recently, endovascular interventions with angioplasty and stenting have become the treatment of choice to prevent amputation and resolve rest pain. Up to 20% of patients with critical limb ischemia are not suitable candidates for a vascular intervention because of extensive occlusions of the outflow in the crural and pedal vessels. This "desert foot" can be treated with a venous arterialization. In this review, we discuss the mechanism, the techniques, outcome, and complications of venous arterialization.
Department of Vascular Surgery, Noordwest Hospital Group, Alkmaar, The Netherlands - m.a.schreve@nwz.nl.
Michiel A
MA
Schreve
Department of Vascular Surgery, Noordwest Hospital Group, Alkmaar, The Netherlands.
Çağdaş
Ç
Ünlü
Unit of Vascular, Department of Surgery, Changi General Hospital, Singapore, Singapore.
Steven
S
Kum
Unit of Vascular, Department of Surgery, Changi General Hospital, Singapore, Singapore.
Yih K
YK
Tan
D001158:Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016638:Critical Illness; D057510:Endovascular Procedures / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D023821:Limb Salvage; D035002:Lower Extremity / Q000098:blood supply*; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D012039:Regional Blood Flow; D012307:Risk Factors; D016896:Treatment Outcome; D014654:Vascular Patency; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D014680:Veins / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*