In critically ill Japanese patients with CLTI, percutaneous deep vein arterialization (DVA) with conventional EVT devices showed an acceptable 1-year salvage rate of 72.2% and a wound healing rate of 53.2%, according to Dr. Tatsuya Nakama of Tokyo Bay Urayasu Ichikawa Medical Center, Japan presented at the Speaker's Corner session at LINC 2022.
Deep Venous Arterialization Procedure for CLTI Patients in Japan.
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The DEPARTURE Japan study retrospectively enrolled 18 patients (18 limbs) treated with DVA with conventional EVT devices at three Japanese centers from January 2016 to November 2020 to evaluate the safety and efficacy of this treatment.
Reasons for DVA included successful EVT but insufficient blood flow (50.0%), guidewire failure (27.8%), device failure (16.7%), and unsuccessful distal bypass (5.6%).
For vein-to-artery connections, VAST or modified VAST technique was used in 72.2% (13 cases), AV Spear technique in 22.2% (4 cases), and re-entry devices in 5.6% (1 case). POBA (50.0%: 9 patients) and cutting balloon (50.0%: 9 patients) were used for valvulotomy. 61.1% (11 patients) had stent grafts and 38.9% (7 patients) had interwoven nitinol stent (IWS).
The procedure success rate was 88.9%, with 4 cases of major amputation within 30 days. These four patients had poor baseline WIfI scores and two patients had unsuccessful DVA. 12-month salvage and survival rates were 72.2% and 76.4%, respectively. 12-month amputation free survival rate was 49.4%, MALE free rate was 50.0%, and 12-month complete wound healing rate was 53.2%. The median time to complete wound healing was 234 days.
Dr. Nakama concluded, "Although there is no dedicated device and this is not yet a standardized treatment, it shows the potential of this treatment."
※コンテンツには、国内で未承認、適応外の医療機器、医薬品、または効能・効果/用法・用量の情報を含む場合がありますが、未承認、適応外の使用を推奨するものではありません。
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