Annals of vascular surgery · 2026
Saphenous Vein Arterialization for Limb Salvage in Unreconstructable Peripheral Arterial Disease: Long-Term Results.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Shoemaker Hailey, Lau David L, Safran Brent A, Brewer Michael B
Аннотация
BACKGROUND: Chronic limb-threatening ischemia (CLTI) is the end stage of peripheral arterial disease, characterized by ischemic rest pain, nonhealing ulcers, or gangrene. Up to 40% of patients lack distal targets for revascularization, often resulting in major amputation. Great saphenous vein arterialization (GSVA) with distal pedal vein valve disruption is a promising limb salvage technique. We report 12-month amputation, pain, and wound healing for patients with CLTI treated with GSVA between 2019 and 2024.
METHODS: From October 2019 to August 2024, 20 limbs in 15 patients with unreconstructable CLTI underwent GSVA. The GSV was used in situ and anastomosed to the most distal patent artery, with central valvulotomy and peripheral valve disruption. Outcomes were assessed through chart review on August 2025.
RESULTS: GSVA was technically successful in all cases without major operative complications. Patients were predominantly male (87%) with mean age 63 years; 87% had diabetes. Follow-up of ≥12 months was available for 14 of 15 patients (19 of 20 limbs). One patient died 327 days post-GSVA without undergoing amputation. Among the 19 limbs with 12-month follow-up, below knee amputation (BKA)-free survival was 53% (10 of 19). Over total study follow-up, BKA-free survival was 55% (11 of 20). In limbs without BKA, 91% demonstrated wound healing and pain improvement. Most amputations (8 of 9) occurred within 1.5 months of GSVA.
CONCLUSION: GSVA with pedal valve disruption offers a viable limb salvage option for patients with unreconstructable CLTI, achieving >50% BKA-free survival at 1 year and substantial wound healing. Larger studies are needed to refine patient selection and optimize outcomes.
METHODS: From October 2019 to August 2024, 20 limbs in 15 patients with unreconstructable CLTI underwent GSVA. The GSV was used in situ and anastomosed to the most distal patent artery, with central valvulotomy and peripheral valve disruption. Outcomes were assessed through chart review on August 2025.
RESULTS: GSVA was technically successful in all cases without major operative complications. Patients were predominantly male (87%) with mean age 63 years; 87% had diabetes. Follow-up of ≥12 months was available for 14 of 15 patients (19 of 20 limbs). One patient died 327 days post-GSVA without undergoing amputation. Among the 19 limbs with 12-month follow-up, below knee amputation (BKA)-free survival was 53% (10 of 19). Over total study follow-up, BKA-free survival was 55% (11 of 20). In limbs without BKA, 91% demonstrated wound healing and pain improvement. Most amputations (8 of 9) occurred within 1.5 months of GSVA.
CONCLUSION: GSVA with pedal valve disruption offers a viable limb salvage option for patients with unreconstructable CLTI, achieving >50% BKA-free survival at 1 year and substantial wound healing. Larger studies are needed to refine patient selection and optimize outcomes.