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 2026021609174716-Feb-2026 09:17 2023032308340423-Mar-2023 08:34 1 MB Preview Print Download
pdf
 et0515 F8 Kum pdf 0644 2026021609174716-Feb-2026 09:17 2022122604531926-Dec-2022 04:53 988 KB Preview Print Download
pdf
 et0521 FT LimFlow pdf 0644 2026021609174716-Feb-2026 09:17 2022122604532026-Dec-2022 04:53 2 MB Preview Print Download
pdf
 manzi2011 pdf 0644 2026021609174716-Feb-2026 09:17 2022122604531926-Dec-2022 04:53 3 MB Preview Print Download

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