30 Mar 2023 • Around 20% of patients with chronic limb-threatening ischemia have no revascularization options, necessitating above-ankle amputation. Transcatheter arterialization of deep veins is a percutaneous procedure that creates an artery-to-vein connection to allow oxygenated blood to be delivered to the ischemic foot via the venous system, preventing amputation. A total of 105 patients with chronic limb-threatening ischemia were enrolled, with a median age of 70 years (interquartile range, 38 to 89). Thirty-three (31.4%) of the patients enrolled were female. In 104 patients (99.0%), transcatheter arterialization of deep veins was successful. At 6 months, 66.1% of patients were amputation-free. The posterior probability that amputation-free survival at 6 months exceeded a performance goal of 54% was 0.993, which exceeded the pre-specified threshold of 0.977, according to Bayesian analysis. Limb salvage (avoiding above-ankle amputation) was achieved in 67 patients (76.0% according to the Kaplan-Meier analysis). Wounds were completely healed in 16 of the 63 patients (25%) and were healing in 32 of the 63 patients (51%). There were no unexpected device-related adverse events reported.

Source: NEJM | Read full story