PMID- 32419597
OWN - NLM
STAT- MEDLINE
DCOM- 20201102
LR  - 20221207
IS  - 1545-1550 (Electronic)
IS  - 1526-6028 (Linking)
VI  - 27
IP  - 4
DP  - 2020 Aug
TI  - Midterm Outcomes of Percutaneous Deep Venous Arterialization With a Dedicated 
      System for Patients With No-Option Chronic Limb-Threatening Ischemia: The ALPS 
      Multicenter Study.
PG  - 658-665
LID - 10.1177/1526602820922179 [doi]
AB  - Purpose: To evaluate the midterm results of patients suffering from no-option 
      chronic limb-threatening ischemia (CLTI) treated with a dedicated system for 
      percutaneous deep venous arterialization (pDVA). Materials and Methods: 
      Thirty-two consecutive CLTI patients (mean age 67+/-14 years; 20 men) treated with 
      pDVA using the Limflow device at 4 centers between 11 July 2014 and 11 June 2018 
      were retrospectively analyzed. Of all patients, 21 (66%) had diabetes, 8 (25%) 
      were on immunosuppression, 4 (16%) had dialysis-dependent renal failure, 9 (28%) 
      had Rutherford category 6 ischemia, and 25 (78%) were deemed at high risk of 
      amputation. The primary outcome was amputation-free survival (AFS) at 6 months. 
      Secondary outcomes were wound healing, limb salvage, and survival at 6, 12, and 
      24 months. Results: Technical success was achieved in 31 patients (96.9%). The 
      median follow-up was 34 months (range 16-63). At 6, 12, and 24 months, estimates 
      were 83.9%, 71.0%, and 67.2% for AFS, 86.8%, 79.8% and 79.8% for limb salvage, 
      and 36.6%, 68.2%, and 72.7% for complete wound healing, respectively. Median time 
      to complete wound healing was 4.9 months (range 0.5-15). The DVA circuit occluded 
      during follow-up in 21 patients; the median time to occlusion was 2.6 months. 
      Reintervention for occlusion was performed in 17 patients: 16 because of unhealed 
      wounds and 1 for a newly developed ulcer. Conclusion: This study represents the 
      largest population of patients with no-option CLTI treated with pDVA using the 
      LimFlow device with midterm results. In this complex group of patients, pDVA 
      using the LimFlow device has been shown to be feasible, with a high technical 
      success rate and AFS at 6 up to 24 months coupled with wound healing. In selected 
      patients with no-option CLTI, pDVA could be a recommended treatment to prevent 
      amputation and heal wounds.
FAU - Schmidt, Andrej
AU  - Schmidt A
AD  - Department of Interventional Angiology, University Hospital Leipzig, Germany.
FAU - Schreve, Michiel A
AU  - Schreve MA
AD  - Department of Surgery, Northwest Clinics, Alkmaar, the Netherlands.
FAU - Huizing, Eline
AU  - Huizing E
AUID- ORCID: 0000-0002-5297-2640
AD  - Department of Surgery, Northwest Clinics, Alkmaar, the Netherlands.
FAU - Del Giudice, Costantino
AU  - Del Giudice C
AD  - Department of Interventional Radiology, Hopital Europeen Georges Pompidou, Paris, 
      France.
FAU - Branzan, Daniela
AU  - Branzan D
AD  - Department of Vascular Surgery, University Hospital Leipzig, Germany.
FAU - Unlu, Cagdas
AU  - Unlu C
AD  - Department of Surgery, Northwest Clinics, Alkmaar, the Netherlands.
FAU - Varcoe, Ramon L
AU  - Varcoe RL
AUID- ORCID: 0000-0001-5611-6991
AD  - Department of Surgery, Prince of Wales Hospital and University of New South 
      Wales, Randwick, Sydney, New South Wales, Australia.
FAU - Ferraresi, Roberto
AU  - Ferraresi R
AD  - Peripheral Interventional Unit, Humanitas Gavazzeni, Bergamo, Italy.
FAU - Kum, Steven
AU  - Kum S
AUID- ORCID: 0000-0003-0883-0829
AD  - Vascular Service, Department of Surgery, Changi General Hospital, Singapore.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20200518
PL  - United States
TA  - J Endovasc Ther
JT  - Journal of endovascular therapy : an official journal of the International 
      Society of Endovascular Specialists
JID - 100896915
SB  - IM
CIN - J Endovasc Ther. 2020 Aug;27(4):666-668. PMID: 32425080
CIN - J Endovasc Ther. 2020 Oct;27(5):873. PMID: 32755326
MH  - Aged
MH  - Aged, 80 and over
MH  - Amputation, Surgical
MH  - Chronic Disease
MH  - Endovascular Procedures/adverse effects/*instrumentation
MH  - Female
MH  - Humans
MH  - Ischemia/diagnostic imaging/physiopathology/*surgery
MH  - Limb Salvage
MH  - Male
MH  - Middle Aged
MH  - Peripheral Vascular Diseases/diagnostic imaging/physiopathology/*surgery
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
MH  - Vascular Patency
MH  - Wound Healing
OTO - NOTNLM
OT  - amputation
OT  - below-the-knee arteries
OT  - chronic limb-threatening ischemia
OT  - critical limb ischemia
OT  - desert foot
OT  - endovascular technique
OT  - infrapopliteal arteries
OT  - limb salvage
OT  - no-option CLTI
OT  - peripheral artery disease
OT  - wound healing
EDAT- 2020/05/19 06:00
MHDA- 2020/11/03 06:00
CRDT- 2020/05/19 06:00
PHST- 2020/05/19 06:00 [pubmed]
PHST- 2020/11/03 06:00 [medline]
PHST- 2020/05/19 06:00 [entrez]
AID - 10.1177/1526602820922179 [doi]
PST - ppublish
SO  - J Endovasc Ther. 2020 Aug;27(4):658-665. doi: 10.1177/1526602820922179. Epub 2020 
      May 18.