Vaskulárna medicína 2/2013

Distal venous arterialization – the penultimate chance for salvage of diabetic foot with critical leg ischemia

The lower extremity occlusive disease, especially in stage of CLI (critical limb ischemia), despite advances in treatment remains a major cause of large limb amputation in diabetic patients. Limb salvage helps to hold the social status of the patient, reduces morbidity and mortality and creates economic benefits for medical services system. The standard revascularization procedures are: surgical treatment (arterio-arterial bypass) and endovascular treatment (PTA). In the group of patients with complete obliteration of metatarsal and foot arteries we can perform reverse venous arterialisation of foot (plus calf). Last alternative to amputation is biological treatment using stem cells or spinal cord stimulation therapy. The method of reverse venous arterialisation is still not fully accepted. The purpose of this article is to point out this method to medical public.

Keywords: diabetic foot, critical limb ischemia, pedal bypass, PTA, inoperable PAOD, venous arterialisation.