Introduction

Last updated: apr 5, 2023

Up to 20% of the CLTI population is estimated to be unreconstructable by means of conventional revascularization techniques due to the absence of a viable target vessel or viable conduit, or the presence of other comorbidities. Without any possibility of revascularization, such “no-option” patients have a dire prognosis, and suffer a high burden of major amputation and mortality.

Introduction

Last updated: apr 5, 2023

Up to 20% of the CLTI population is estimated to be unreconstructable by means of conventional revascularization techniques due to the absence of a viable target vessel or viable conduit, or the presence of other comorbidities. Without any possibility of revascularization, such “no-option” patients have a dire prognosis, and suffer a high burden of major amputation and mortality.

Percutaneous deep vein arterialization (pDVA) has recently been shown to provide a promising treatment alternative for no-option patients.

 

Presentation

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Limflow
 

Anatomy

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Indications

  • No conventional surgical or endovascular treatment options available, or
  • Two previous crural interventions without clinical improvement.
  • Target Inflow Artery: To be treated with a 3.5-4.0 mm stent and <50% stenosis.

 

Contra indications

  • Liver failure
  • Deep vein thrombosis (DVT) in the target limb
  • Uncorrected coagulopathy
  • Immunodeficiency
  • GFR < 30
  • Popliteal aneurysm
  • Acute limb ischemia
  • Myocardial infarction (MI) or cerebrovascular accident (CVA) within the last 90 days
  • WIfI foot infection, grade 3
  • Venous disease with edema that hinders the procedure
  • Severe heart failure
  • Life expectancy < 12 months
  • Pregnancy or lactation
  • Presence of a bypass that obstructs proximal inflow to the stent
  • Allergies or contraindications that may interfere with the procedure

 

Workup

 

Pre procedural

 

Materials

Essentials

Non-Essentials

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Positioning the patient

Supine
Feet first

 

The procedure in steps

  • Time Out Procedure
  • Patient Positioning: Ensure proper positioning for the procedure.
  • Preparation: Wash the area with chlorhexidine and apply sterile drapes.
  • Refer to Video Tutorial: See the YouTube link provided for additional guidance.
  • Sign Out Procedure

 

Tips and tricks

 

Complications

Limflow
 

Aftercare

 

Report

 

Patient folder

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Literature

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pdf
 Promis I pdf 0644 2025070109252101-Jul-2025 09:25 2023032308340423-Mar-2023 08:34 1 MB Preview Print Download
pdf
 et0515 F8 Kum pdf 0644 2025070109252101-Jul-2025 09:25 2022122604531926-Dec-2022 04:53 988 KB Preview Print Download
pdf
 et0521 FT LimFlow pdf 0644 2025070109252101-Jul-2025 09:25 2022122604532026-Dec-2022 04:53 2 MB Preview Print Download
pdf
 manzi2011 pdf 0644 2025070109252101-Jul-2025 09:25 2022122604531926-Dec-2022 04:53 3 MB Preview Print Download

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The information contained herein has been obtained from sources believed to be reliable. However, no warranty as to the accuracy, completeness or adequacy of such information is implied. No liability is accepted for errors, omissions or inadequacies in the information contained herein or for interpretations thereof. The reader assumes sole responsibility for the selection of these materials to achieve its intended results. The opinions expressed herein are subject to change without notice.

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