Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.202300771
Jornal Vascular Brasileiro
Original Article

Arterialização venosa superficial com veia safena magna in situ: a experiência de um único centro

Superficial venous arterialization with the great saphenous vein in situ: a single-center experience

Karlene Thayane Barros da Silva; Marcos Antonio Bonacorso Manhanelli Filho; José Francisco Moron Morad; Fábio Linardi; José Augusto Costa

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Resumo

Contexto: A arterialização do arco venoso dorsal do pé é uma técnica indicada em casos de isquemia crítica de membros inferiores sem leito distal adequado que possibilite tratamento convencional, como revascularização, angioplastia ou tratamento clínico.

Objetivos: O propósito do trabalho foi apresentar o resultado da arterialização do arco venoso do pé em 16 pacientes submetidos a essa técnica.

Métodos: Tratou-se de um estudo analítico descritivo retrospectivo transversal, baseado na revisão de prontuários de 16 pacientes submetidos à arterialização do arco venoso dorsal do pé para salvamento de membro, entre janeiro de 2016 a janeiro de 2021.

Resultados: Dos 16 pacientes submetidos à arterialização do arco venoso do pé, 25% (4) evoluíram para amputação maior durante a mesma internação, e 6,25% (1) pacientes evoluíram para amputação maior após 6 meses. Os demais pacientes (68,75%, 11) tiveram seus membros preservados, sendo que 10 foram submetidos a amputações menores (pododáctilos e antepé), e 1 paciente não necessitou de procedimento adicional.

Conclusões: A técnica de arterialização do arco venoso dorsal do pé deve ser considerada em casos selecionados. Trata-se de uma alternativa válida para a preservação do membro na impossibilidade de tratamento convencional.

Palavras-chave

isquemia crítica; preservação do membro; salvamento de membro; arterialização do arco venoso do pé

Abstract

Background: Arterialization of the dorsal venous arch of the foot is a technique indicated in cases of critical lower limb ischemia that do not have a distal bed that is adequate to enable conventional treatment such as revascularization, angioplasty, or clinical treatment.

Objectives: The purpose of this study is to present the result of arterialization of the venous arch of the foot in 16 patients who underwent treatment with this technique.

Methods: This is a cross-sectional retrospective descriptive analytical study based on a review of the medical records of 16 patients who underwent arterialization of the dorsal venous arch of the foot for limb salvage from January 2016 to January 2021.

Results: Four (25%) of the 16 patients who underwent arterialization of the venous arch of the foot underwent a major amputation during the same hospital stay and one patient (6.25%) had a major amputation within 6 months. The other 11 patients (68.75%) had their limbs preserved, with 10 undergoing minor amputations (toes and forefoot) and one patient having no additional procedures. 

Conclusions: We conclude that the technique of arterialization of the dorsal venous arch of the foot should be considered in selected cases. It is a valid alternative for limb salvage when conventional treatment is impossible.

Keywords

critical ischemia; limb preservation; limb salvation; arterialization of the venous arch of the foot

References

1 Busato CR, Utrabo CAL, Gomes RZ, et al. Arterialização do arco venoso do pé para tratamento da tromboangeíte obliterante. J Vasc Bras. 2008;7(3):267-71. http://dx.doi.org/10.1590/S1677-54492008000300013.

2 Lu XW, Idu MM, Ubbink DT, Legemate DA. Meta-analysis of the clinical effectiveness of venous arterialization for salvage of critically ischaemic limbs. Eur J Vasc Endovasc Surg. 2006;31(5):493-9. http://dx.doi.org/10.1016/j.ejvs.2005.12.017. PMid:16488164.

3 Gasparis AP, Noor S, da Silva MS, Tassiopoulos AK, Semel L. Distal venous arterialization for limb salvage a case report. Vasc Endovascular Surg. 2002;36(6):469-72. http://dx.doi.org/10.1177/153857440203600609. PMid:12476238.

4 Engelke C, Morgan RA, Quarmby JW, Taylor RS, Belli AM. Distal venous arterialization for lower limb salvage: angiographic appearances and interventional procedures. Radiographics. 2001;21(5):1239-48. http://dx.doi.org/10.1148/radiographics.21.5.g01se281239. PMid:11553829.

5 Rowe VL, Hood DB, Lipham J, et al. Initial experience with dorsal venous arch arterialization for limb salvage. Ann Vasc Surg. 2002;16(2):187-92. http://dx.doi.org/10.1007/s10016-001-0148-y. PMid:11972250.

6 Koyama T, Sugihara-Seki M, Sasajima T, Kikuchi S. Venular valves and retrograde perfusion. In: Swartz HM, Harrison DK, Bruley DF, editors. Oxygen transport to tissue XXXVI. New York: Springer; 2014. (Advances in Experimental Medicine and Biology; no. 812). http://dx.doi.org/10.1007/978-1-4939-0620-8_42.

7 Sasajima T, Kikuchi S, Ishikawa N, Koyama T. Skin temperature in lower hind limb subjected to distal vein arterialization in rats. In: Swartz HM, Harrison DK, Bruley DF, editors. Oxygen transport to tissue XXXVI. New York: Springer; 2014. (Advances in Experimental Medicine and Biology; no. 812). http://dx.doi.org/10.1007/978-1-4939-0620-8_48.

8 Lengua F, La Madrid A, Acosta C, et al. L’artérialisation des veines du pied pour sauvetage de membre chez l’artéritique: technique et résultats. Ann Chir. 2001;126(7):629-36. http://dx.doi.org/10.1016/S0003-3944(01)00585-5. PMid:11676233.

9 Keshelava G, Gigilashvili K, Chkholaria A, Pagava G, Janashia G, Beselia K. Foot venous system arterialization for salvage of nonreconstructable acute ischemic limb: a case report. J Vasc Nurs. 2009;27(1):13-6. http://dx.doi.org/10.1016/j.jvn.2008.10.002. PMid:19217540.

10 Schreve MA, Vos CG, Vahl AC, et al. Venous arterialisation for salvage of critically ischaemic limbs: a systematic review and meta-analysis. Eur J Vasc Endovasc Surg. 2017;53(3):387-402. http://dx.doi.org/10.1016/j.ejvs.2016.11.007. PMid:28027892.

11 Mutirangura P, Ruangsetakit C, Wongwanit C, Sermsathanasawadi N, Chinsakchai K. Pedal bypass with deep venous arterialization: the therapeutic option in critical limb ischemia and unreconstructable distal arteries. Vascular. 2011;19(6):313-9. http://dx.doi.org/10.1258/vasc.2010.oa0278. PMid:22008976.

12 Sprengers RW, Teraa M, Moll FL, de Wit GA, van der Graaf Y, Verhaar MC. Quality of life in patients with no-option critical limb ischemia underlines the need for new effective treatment. J Vasc Surg. 2010;52(4):843-9. http://dx.doi.org/10.1016/j.jvs.2010.04.057. PMid:20598482.

13 Alexandrescu V, Ngongang C, Vincent G, Ledent G, Hubermont G. Deep calf veins arterialization for inferior limb preservation in diabetic patients with extended ischaemic wounds, unfit for direct arterial reconstruction: preliminary results according to an angiosome model of perfusion. Cardiovasc Revasc Med. 2011;12(1):10-9. http://dx.doi.org/10.1016/j.carrev.2009.12.002. PMid:21241966.

14 Nguyen PSA, Legré R, Gay AM. Treatment of hand ischemia with arterialization of the venous system of the hand: report of three cases. Ann Chir Plast Esthet. 2011;56(3):200-6. http://dx.doi.org/10.1016/j.anplas.2010.12.005. PMid:21296474.

15 Ichihashi S, Shimohara Y, Bolstad F, Iwakoshi S, Kichikawa K. Simplified endovascular deep venous arterialization for non-option cli patients by percutaneous direct needle puncture of tibial artery and vein under ultrasound guidance (AV Spear Technique). Cardiovasc Intervent Radiol. 2020;43(2):339-43. http://dx.doi.org/10.1007/s00270-019-02388-2. PMid:31797100.

16 Wahlberg E. Angiogenesis and arteriogenesis in limb ischemia. J Vasc Surg. 2003;38(1):198-203. http://dx.doi.org/10.1016/S0741-5214(03)00151-4. PMid:12844115.

17 Schreve MA, Ünlü Ç, Kum S, Tan YK. Surgical and endovascular venous arterialization: ready to take the “desert” by storm? J Cardiovasc Surg. 2017;58(3):402-8. http://dx.doi.org/10.23736/S0021-9509.17.09844-5. PMid:28155264.

18 Houlind K, Christensen J, Hallenberg C, Jepsen JM. Early results from an angiosome-directed open surgical technique for venous arterialization in patients with critical lower limb ischemia. Diabet Foot Ankle. 2013;4(1):22713. http://dx.doi.org/10.3402/dfa.v4i0.22713. PMid:24358432.

19 Schreve MA, Minnee RC, Bosma J, Leijdekkers VJ, Idu MM, Vahl AC. Comparative study of venous arterialization and pedal bypass in a patient cohort with critical limb ischemia. Ann Vasc Surg. 2014;28(5):1123-7. http://dx.doi.org/10.1016/j.avsg.2013.08.010. PMid:24189192.
 


Submitted date:
06/15/2023

Accepted date:
09/20/2023

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
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