Madabhushi Vashisht, Dunlap Eleanor, Nagarsheth Khanjan
Division of Vascular Surgery, Department of Surgery, University of Maryland Medical Center, Baltimore, MD.
J Vasc Surg Cases Innov Tech. 2025 Jan 15;11(3):101738. doi: 10.1016/j.jvscit.2025.101738. eCollection 2025 Jun.
Inflow and outflow are the foundational principles of vascular surgery. This especially holds true in patients with peripheral arterial disease with chronic limb-threatening ischemia, who have a long segment occlusion of the superficial femoral artery and infrageniculate disease with inadequate distal targets for a bypass. Percutaneous transmural arterial bypass (PTAB) has demonstrated excellent results the endovascular management of femoropopliteal occlusive disease. However, without adequate outflow, the PTAB will not stay patent. Deep venous arterialization has shown promise in patients with inadequate outflow to the foot. Herein, we describe the first known experience of concomitant PTAB and deep venous arterialization to treat CTLI.
流入和流出是血管外科的基本原则。这在患有慢性肢体威胁性缺血的外周动脉疾病患者中尤其如此，这些患者存在股浅动脉长段闭塞以及膝下疾病，且远端靶血管不足以进行旁路移植。经皮经腔动脉旁路移植术（PTAB）已在股腘动脉闭塞性疾病的血管内治疗中显示出优异的效果。然而，如果没有足够的流出道，PTAB将无法保持通畅。对于足部流出道不足的患者，深静脉动脉化已显示出前景。在此，我们描述了首例已知的同时进行PTAB和深静脉动脉化治疗慢性肢体威胁性缺血的经验。
