Ichihashi Shigeo, Iwakoshi Shinichi, Nakai Takahiro, Yamamoto Yuji, Hirose Tomoaki, Furuichi Kinya, Tamura Yamato, Tanaka Toshihiro
Department of Diagnostic and Interventional Radiology, Nara Medical University, Japan.
Department of Thoracic and Cardiovascular Surgery, Nara Medical University, Japan.
Interv Radiol (Higashimatsuyama). 2023 Jul 1;8(2):97-104. doi: 10.22575/interventionalradiology.2022-0025.
Efficacy of percutaneous deep venous arterialization (pDVA) has been reported for patients with no-option chronic limb-threatening ischemia (CLTI). In the countries where a manufactured device dedicated for pDVA has not been reimbursed, pDVA using the off-the-shelf technique has alternatively spread. The off-the-shelf techniques for arteriovenous fistula (AVF) creation reported are as follows: AV spear technique, venous arterialization simplified technique (VAST), and a use of penetration guidewire or a reentry device. Technical success rates of the procedures are similar to those using the dedicated device. pDVA could be a last resort for the patients with no-option CLTI, including those suffering from stump ulcer after major limb amputation or those with occluded surgical bypass.
经皮深静脉动脉化（pDVA）已被报道对无可选择的慢性肢体威胁性缺血（CLTI）患者有效。在尚未报销专门用于pDVA的制造设备的国家，采用现成技术的pDVA已得到推广。已报道的用于创建动静脉瘘（AVF）的现成技术如下：AV穿刺技术、简化静脉动脉化技术（VAST）以及使用穿刺导丝或再入装置。这些手术的技术成功率与使用专用设备的成功率相似。pDVA可能是无可选择的CLTI患者的最后手段，包括那些在大肢体截肢后患有残端溃疡的患者或手术旁路闭塞的患者。
