Ferrer Lucas, Malin Lynsey, Koutakis Panagiotis, Miserlis Dimitrios
Vascular and Endovascular Surgery, University of Texas at Austin Dell Medical School, Austin, TX, USA.
Department of Public Health, College of Health, University of West Florida, Pensacola, FL, USA.
Sci Prog. 2025 Apr-Jun;108(2):368504251352033. doi: 10.1177/00368504251352033. Epub 2025 Jun 25.
Chronic limb-threatening ischemia represents the most severe form of peripheral arterial disease, with a 40% amputation rate and 20% mortality at 6 months without revascularization. Deep venous arterialization is an alternative for patients with advanced peripheral arterial disease who have no conventional revascularization surgery option based on their anatomy-no distal artery target to redirect arterial blood. Hybrid deep venous arterialization, which combines open surgical bypass with venous endovascular arterialization and valvulotomy, is a technique under investigation for limb salvage with limited current long-term data. We present a successful limb salvage case report of an early 60s male with no conventional revascularization options who presented with a wound in his foot and underwent a successful hybrid deep venous arterialization. The hybrid deep venous arterialization technique has shown promising preliminary results for long-term limb salvage at 5 years after surgery. This case report establishes a tangible example of the potential role of hybrid deep venous arterialization in the management of patients with no-option chronic limb-threatening ischemia. After a 5-year follow-up, the reported patient has no ischemic symptoms, and he is able to ambulate without support.
慢性肢体威胁性缺血是外周动脉疾病最严重的形式，在未经血运重建的情况下，6个月时截肢率为40%，死亡率为20%。对于因解剖结构原因没有传统血运重建手术选择（即没有可重定向动脉血的远端动脉靶点）的晚期外周动脉疾病患者，深静脉动脉化是一种替代方案。混合式深静脉动脉化将开放手术旁路与静脉腔内动脉化及瓣膜切开术相结合，是一种正在研究的用于肢体挽救的技术，目前长期数据有限。我们报告一例成功的肢体挽救病例，患者为一名60岁出头男性，没有传统血运重建选择，足部有伤口，接受了成功的混合式深静脉动脉化手术。混合式深静脉动脉化技术在术后5年的长期肢体挽救方面已显示出有前景的初步结果。本病例报告为混合式深静脉动脉化在无可选择的慢性肢体威胁性缺血患者管理中的潜在作用树立了一个切实的范例。经过5年随访，该报告患者没有缺血症状，能够在无支撑的情况下行走。
