OBJECTIVE: Lower limb arterial occlusion with no patent distal artery suitable for revascularisation is a common problem. The aim of this study was to assess the role of revascularisation to distal veins (ascending venous arterialization) in patients not reconstructable by conventional bypass. METHOD: Ascending venous arterialization is a distal arteriovenous fistula. Reversed great saphenous vein grafts, from above the knee, were anastomosed to the common femoral artery, superficial femoral artery or popliteal artery and distally to the saphenous vein at the level of medial malleolus. No intervention was done to destroy the venous valves. The great saphenous vein was ligated below the knee. In this way, oxygenated blood could reach to dorsal venous arch and the tissues below the knee in an ascending fashion through the great saphenous vein, which was not removed. RESULTS: All of the patients recovered immediately after the operation. The lesions on the feet and on the toes of the patients improved in a short time. Intermittent claudication of the patients disappeared. Strong pulses were detected on the dorsal venous arch with manual Doppler in 3 weeks. The below knee tissues were perfused with the applied technique. CONCLUSION: Ascending venous arterialization can be applied for limb salvage to the patients who do not have a suitable arterial bed to revascularize with conventional techniques.
OBJECTIVE: Lower limb arterial occlusion with no patent distal artery suitable for revascularisation is a common problem. The aim of this study was to assess the role of revascularisation to distal veins (ascending venous arterialization) in patients not reconstructable by conventional bypass. METHOD: Ascending venous arterialization is a distal arteriovenous fistula. Reversed great saphenous vein grafts, from above the knee, were anastomosed to the common femoral artery, superficial femoral artery or popliteal artery and distally to the saphenous vein at the level of medial malleolus. No intervention was done to destroy the venous valves. The great saphenous vein was ligated below the knee. In this way, oxygenated blood could reach to dorsal venous arch and the tissues below the knee in an ascending fashion through the great saphenous vein, which was not removed. RESULTS: All of the patients recovered immediately after the operation. The lesions on the feet and on the toes of the patients improved in a short time. Intermittent claudication of the patients disappeared. Strong pulses were detected on the dorsal venous arch with manual Doppler in 3 weeks. The below knee tissues were perfused with the applied technique. CONCLUSION: Ascending venous arterialization can be applied for limb salvage to the patients who do not have a suitable arterial bed to revascularize with conventional techniques.
Authors: Cesar Roberto Busato; Carlos Alberto Lima Utrabo; Leandro Cavalcante Lipinski; Marcelo de Oliveira Dreweck; Ana Carolina Viezzer Fernandes; Gabriel Sviercoski Journal: J Vasc Bras Date: 2020-07-31
Authors: Cesar Roberto Busato; Carlos Alberto Lima Utrabo; Leandro Cavalcante Lipinski; Mario Rodrigues Montemór; Eduardo de Souza Tolentino; Fernanda Aparecida de Oliveira Busato Nascimento; Marcio Dias Guilherme Journal: J Vasc Bras Date: 2016 Apr-Jun
Authors: Cesar Roberto Busato; Carlos Alberto Lima Utrabo; Leandro Cavalcante Lipinski; Keizi Dayane de Lima; Márcio Dias Guilherme; Nicolas Brandalize Medeiros; Samela Basi Fagundes; Willman Josviak Journal: J Vasc Bras Date: 2017 Jul-Sep