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Endovascular and Surgical Venous Arterialization for No-Option Patients With Chronic Limb-Threatening Ischemia: A Systematic Review and Meta-Analysis.
Ucci, Alessandro; Perini, Paolo; Freyrie, Antonio; Schreve, Michiel A; Ünlü, Çagdas; Huizing, Eline; van den Heuvel, Daniel A; Kum, Steven; Shishehbor, Mehdi H; Ferraresi, Roberto.
Afiliación
  • Ucci A; Vascular Surgery, Department of Medicine and Surgery, University of Parma, Parma, Italy.
  • Perini P; Vascular Surgery, Department of Medicine and Surgery, University of Parma, Parma, Italy.
  • Freyrie A; Vascular Surgery, Department of Medicine and Surgery, University of Parma, Parma, Italy.
  • Schreve MA; Department of Vascular Surgery, Northwest Clinics, Alkmaar, the Netherlands.
  • Ünlü Ç; Department of Vascular Surgery, Northwest Clinics, Alkmaar, the Netherlands.
  • Huizing E; Department of Radiology, Spaarne Hospital, Haarlem, the Netherlands.
  • van den Heuvel DA; Department of Radiology, St. Antonius Hospital, Nieuwegein, the Netherlands.
  • Kum S; Vascular Service, Department of Surgery, Changi General Hospital, Singapore.
  • Shishehbor MH; University Hospitals Harrington Heart and Vascular Institute, Cleveland, OH, USA.
  • Ferraresi R; Diabetic Foot Unit, San Carlo Clinic, Paderno Dugnano, Italy.
J Endovasc Ther ; : 15266028231210220, 2023 Nov 27.
Article en En | MEDLINE | ID: mdl-38009322
ABSTRACT

BACKGROUND:

Chronic limb-threatening ischemia (CLTI) is known for its high rates of major amputation and mortality. Conventional revascularization techniques often fail in CLTI patients due to the heavily diseased arteries. Foot vein arterialization (FVA) has been proposed as an alternative technique to provide arterial blood to the foot by using the disease-free venous bed.

OBJECTIVES:

This systematic review and meta-analysis aimed to determine outcomes of surgical FVA (sFVA) and percutaneous FVA (pFVA) at 6 and 12 months post-procedure. DATA SOURCES PubMed, Scopus, Web of Science, and the Cochrane Library databases were searched to identify papers reporting clinical outcomes of sFVA and pFVA published between January 1966 and March 2023.

METHODS:

Databases were searched for eligible studies. A meta-analysis was performed to evaluate the limb salvage rate, overall survival rate, and wound healing rate at 6 and 12 months.

RESULTS:

A total of 27 studies were included, with 753 patients and 793 limbs. Of the included studies, 16 analyzed the sFVA technique and 11 the pFVA technique. Of the included patients, 86.3% were Rutherford 5/6 in the sFVA group versus 98.4% in the pFVA group. The pooled limb salvage rate at 6 and 12 months was 78.1% and 74.1% in the sFVA group and 81.7% and 78.6% in the pFVA group, respectively. Wound healing rates were not reported in the sFVA group. In the pFVA group, the pooled wound healing rates were 48.1% and 64.5% at 6 and 12 months, respectively.

CONCLUSION:

This study showed promising results after FVA among a large population of CLTI patients. In high-risk patients, pFVA is a feasible option with favorable limb salvage and wound healing rates.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Tipo de estudio: Systematic_reviews Idioma: En Revista: J Endovasc Ther Asunto de la revista: ANGIOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Italia

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Tipo de estudio: Systematic_reviews Idioma: En Revista: J Endovasc Ther Asunto de la revista: ANGIOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Italia