Zhang Jackie M, Zambetti Benjamin R, Chaudhary Mirnal A, Chaparala Swati, Nagarsheth Khanjan
Division of Vascular Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD.
J Vasc Surg Cases Innov Tech. 2024 May 23;10(5):101545. doi: 10.1016/j.jvscit.2024.101545. eCollection 2024 Oct.
Patients with no-option chronic limb-threatening ischemia are not candidates for conventional revascularization options and will inevitably require major amputation. Deep venous arterialization (DVA) is a potential option for these patients. A complete endovascular system to perform DVA has recently received great acclaim and US Foor and Drug Administration approval. However, patients with severe tibial medial calcinosis such as those with diabetes or renal failure may not be candidates for this because most endovascular needles cannot penetrate severe calcium. Here we describe a novel hybrid approach to DVA that provided technical success in three patients with end-stage renal disease and severe medial calcinosis.
对于无可选择的慢性肢体威胁性缺血患者，传统的血运重建方法并不适用，他们最终不可避免地需要进行大截肢手术。对于这些患者而言，深静脉动脉化（DVA）是一种可行的选择。一种用于实施DVA的完整血管内系统最近备受赞誉并获得了美国食品药品监督管理局的批准。然而，患有严重胫内侧钙化的患者，如糖尿病或肾衰竭患者，可能并不适合这种方法，因为大多数血管内穿刺针无法穿透严重的钙化区域。在此，我们描述了一种新型的DVA混合方法，该方法在三名患有终末期肾病和严重内侧钙化的患者中取得了技术上的成功。
