Percutaneous deep venous arterialisation for chronic limb-threatening ischaemia
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3 Committee considerations
The evidence
3.1 NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 6 sources, which was discussed by the committee. The evidence included 1 feasibility study, 1 pilot study, and 4 case series. It is presented in the summary of key evidence section in the interventional procedures overview. Other relevant literature is in the appendix of the overview.
3.2 The professional experts and the committee considered the key efficacy outcomes to be: improvement in limb perfusion, reduction in amputation and quality of life.
3.3 The professional experts and the committee considered the key safety outcomes to be: pain, bleeding, infection, worsening of perfusion, steal syndrome and major adverse cardiovascular events.
3.4 Three commentaries from people who have had this procedure were discussed by the committee.
Committee comments
3.5 A significant number of patients needed both planned and unplanned reinterventions.
3.6 The committee was informed that patient selection and postprocedural surveillance are important, and that patients should be followed up for life.
3.7 The committee was informed that this is a challenging procedure, and that it should only be done by clinicians with specific training and experience in this technique.
Tom Clutton-Brock
Chair, interventional procedures advisory committee
March 2023
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