Open Distal Venous Arterialization Technique as an Opportunity for Patients With Critical Limb Ischemia: A Latin American Experience

Background: Chronic limb-threatening ischemia (CLTI) leads to decreased quality of life and increased disease burden, resulting in progressive patient deterioration, limb amputation, and mortality. Objectives: This study aims to present the outcomes of a Latin American experience using the open distal venous arterialization (DVA) technique for no-option limb salvage in a high volume CLTI center. Methods: A retrospective case series study was performed including patients from 2018 to 2022 using a population from Bogotá, Colombia. Patients with no-option chronic limb-threatening ischemia underwent open DVA with a 12 month follow-up period. Variables such as operative time, hospital and ICU length of stay, graft material, re-interventions, 1-year patency, amputations and 1-year mortality were recorded. Results: 5 patients with a mean age of 71 years were intervened. 60% were male and 80% had a diabetes mellitus diagnosis. Four patients underwent a reverse great saphenous vein graft procedure and 1 composite polytetrafluoroethylene graft. A total of 80% of patients demonstrated graft patency after 1 year. No perioperative mortalities were recorded but one late postoperative mortality due to myocardial infarction occurred. One major amputation was required, minor amputations were performed in 2 of the patients. Conclusion: Open DVA is a feasible low cost technique for adequately selected patients with favorable saphenous vein, as evidenced by the limb salvage and graft patency outcomes.