Percutaneous deep venous arterialization with balloon angioplasty salvaged a life‐threatening critical limb in a hemodialysis patient after repeated pedal angioplasty failed: A case report

• DOI: 10.1002/ccr3.7589
• Publication Date: 2023-06-21T04:38:21Z
• Authors: Tomonari Takagi; Akira Miyamoto; Norihiko Ohura; Yasutaka Yamauchi
• Keywords: Critical limb ischemia

Chronic limb-threatening ischemia (CLTI) with severe below-the-ankle (BTA) lesions is often difficult to revascularize endovascular treatment (EVT) and surgical treatment. We present a case of successful limb salvage using percutaneous deep venous arterialization (pDVA) in patient CLTI whose BTA lesion reconstruction failed. A 57-year-old man diabetes mellitus end-stage renal failure on maintenance hemodialysis was referred our hospital because gangrene the second third toes his left foot. EVT repeated for anterior tibial artery, posterior artery (PTA), dorsal foot plantar lesions; however, revascularization below ankle unsuccessful. As infection had spread sole foot, below-the-knee amputation indicated, but refused. Therefore, we performed pDVA PTA simultaneously Lisfranc amputation. An arteriovenous fistula created at joint Venous Arterialization Simplified Technique guidewire inserted into vein. Balloon dilatation from vein complete pDVA. Although required maintain blood flow pDVA, skin grafting 3 months after wound completely healed, he discharged 6 DVA. The can be an option patients no-option who are confronted by imminent