Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492008000300013
Jornal Vascular Brasileiro
Case Report

Arterialização do arco venoso do pé para tratamento da tromboangeíte obliterante

Arterialization of the venous arch of the foot for the treatment of thromboangiitis obliterans

Cesar Roberto Busato; Carlos Alberto Lima Utrabo; Ricardo Zanetti Gomes; Joel Kengi Housome; Eliziane Hoeldtke; Cristiano Teixeira Pinto; Rafael Ignácio Brandão; Cintia Doná Busato

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Resumo

Em isquemia crítica sem leito arterial distal, um dos modos de irrigar o membro isquêmico é derivar o fluxo de maneira retrógrada através do sistema venoso. As primeiras tentativas de fístulas arteriovenosas terapêuticas datam do início do século passado. Realizadas na parte proximal dos membros inferiores, não obtiveram resultados favoráveis. A partir da década de 70, com os trabalhos pioneiros de Lengua, as fístulas passaram a ser estendidas até o pé, e os bons resultados apareceram em várias publicações. Os autores relatam a evolução de um caso de tromboangeíte obliterante submetida ao procedimento. Essa é uma cirurgia de indicação precisa, que requer estudo pré-operatório arterial e venoso e observância a detalhes de técnica operatória.

Palavras-chave

Arterialização venosa, isquemia crítica, fístulas arteriovenosas terapêuticas, salvamento de membro, tromboangeíte obliterante

Abstract

In critical ischemia without arterial run-off, it is possible to irrigate the ischemic limb by turning the course of the flow reversely through the venous system. The first experiments with therapeutic arteriovenous fistulas date from the beginning of the last century. They were performed in the proximal area of the lower limbs, but showed unfavorable results. Since the 1970's, with the pioneer studies of Lengua, fistulas started being extended to the foot and several publications have reported good outcomes. The authors report the evolution of a case of thromboangiitis obliterans which was submitted to the procedure. This is an accurate surgical procedure which requires arterial and venous preoperative study and the observance of technical operative details.

Keywords

Venous arterialization, critical ischemia, therapeutic arteriovenous fistulas, limb salvage, thromboangiitis obliterans

References

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