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    The content on this page is not current guidance and is only for the purposes of the consultation process.

    Superficial venous arterialisation and selective venous occlusion for chronic limb threatening ischaemia in people with no other option for revascularisation

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    1 Draft recommendations

    1.1 Evidence on the safety of superficial venous arterialisation and selective venous occlusion for chronic limb threatening ischaemia in people with no other option for revascularisation shows well-recognised complications. Evidence on its efficacy is inadequate in quantity and quality. However, because this guidance covers people who have no other treatment options, this procedure can be used with special arrangements for clinical governance, consent, and audit or research. Find out what special arrangements mean on the NICE interventional procedures guidance page.

    1.2 Clinicians wanting to do superficial venous arterialisation and selective venous occlusion for chronic limb threatening ischaemia in people with no other option for revascularisation should:

    • Inform the clinical governance leads in their healthcare organisation.

    • Give people (and their families and carers as appropriate) clear written information to support shared decision making, including NICE's information for the public.

    • Ensure that people (and their families and carers as appropriate) understand the procedure's safety and efficacy, and any uncertainties about these.

    • Audit and review clinical outcomes of everyone having the procedure. The main efficacy and safety outcomes identified in this guidance can be entered into NICE's interventional procedure outcomes audit tool (for use at local discretion).

    • Discuss the outcomes of the procedure during their annual appraisal to reflect, learn and improve.

      1.3 Healthcare organisations should:

      • Ensure systems are in place that support clinicians to collect and report data on outcomes and safety for everyone having this procedure.

      • Regularly review data on outcomes and safety for this procedure.

        1.4 Patient selection should be done by a multidisciplinary team with specialist expertise in managing chronic limb threatening ischaemia.

        1.5 The procedure should only be done in specialist centres by surgeons with specific training and experience in this procedure.