Simultaneous great saphenous vein arterialization and drug-eluting balloon venous angioplasty in no-option chronic limb-threatening ischemia: a case report

In young patients with Chronic Limb-Threatening Ischemia (CLTI) with inadequate arterial networks for revascularization, unconventional approaches can be justified before a major amputation. We report a case of a young man, with critical ischemia unsuitable for conventional revascularization interventions. Subjected to Common Femoral Artery (CFA) and Deep Femoral Artery (DFA) endarterectomy and Dacron patch and hybrid venous arterialization technique with anastomosis of the great saphenous vein to the Dacron patch and paclitaxel-coated Percutaneous Transluminal Angioplasty (PTA) balloon catheter angioplasty of the great saphenous vein. The success of the procedure is confirmed by the healing of the trophic lesion. Arterialization of the venous system is an option in salvage treatments and can be performed in both the deep and superficial systems by connecting the arterial and venous systems. Several hybrid techniques are available with comparable results. There is no consensus on the best treatment strategy for venous arterialization for limb salvage.