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一份关于实施下肢体外远端血管重建术(LEEDR)作为急性肢体缺血确定性治疗桥梁的拟议临床指南。

A proposed clinical guide to delivering Lower Extremity Extracorporeal Distal Revascularization (LEEDR) as a bridge to definitive care in acute limb ischemia.

作者信息

Dvir May, Jodlowski Grzegorz, Stonko David P, Treffalls Rebecca, Nelson Jack, Walker Patrick F, Morrison Jonathan J

机构信息

Department of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN, USA.

Division of Vascular and Endovascular Surgery, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

出版信息

Perfusion. 2025 Jul 24:2676591251363374. doi: 10.1177/02676591251363374.

Abstract

IntroductionLower Extremity Extracorporeal Distal Revascularization (LEEDR) is a novel, preclinically tested technique designed to provide temporary limb perfusion in cases of acute limb ischemia when immediate revascularization is not feasible.MethodsLEEDR employs an extracorporeal pump and circuit to draw arterial blood from a proximal inflow site and deliver it to an outflow artery within the ischemic limb. The system is designed for bedside initiation using percutaneous access.ResultsALI from embolism, thrombosis, or trauma rapidly leads to irreversible tissue damage. Delays in revascularization are associated with high rates of limb loss and systemic complications. LEEDR offers a time-sensitive intervention aimed at mitigating these risks and preserving limb viability until definitive treatment is available.ConclusionLEEDR is a promising temporary perfusion strategy for limb salvage in ALI. This manuscript outlines its procedural components, technical considerations, and anticipated role in bridging patients to definitive revascularization.

摘要

引言

下肢体外远端血管重建术(LEEDR)是一种经过临床前测试的新型技术,旨在在无法立即进行血管重建的急性肢体缺血病例中提供临时肢体灌注。

方法

LEEDR采用体外泵和循环系统,从近端流入部位抽取动脉血,并将其输送到缺血肢体的流出动脉。该系统设计为通过经皮穿刺在床边启动。

结果

由栓塞、血栓形成或创伤引起的急性肢体缺血会迅速导致不可逆的组织损伤。血管重建的延迟与高截肢率和全身并发症相关。LEEDR提供了一种时间敏感的干预措施,旨在降低这些风险并在进行确定性治疗之前保持肢体的存活能力。

结论

LEEDR是一种有前景的用于急性肢体缺血肢体挽救的临时灌注策略。本文概述了其操作步骤、技术要点以及在将患者过渡到确定性血管重建中的预期作用。

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