Hybrid superficial venous arterialization limb salvage for “full metal jacket” peripheral arterial stenting and no-option chronic limb-threatening ischemia: A case report

Chronic limb-threatening ischemia (CLTI) remains a challenge, especially in the ultra-complex patient population with a history of extensive endovascular revascularization and peripheral arterial stenting. For patients with no conventional revascularization options, endovascular venous arterialization (EVVA) has emerged as a promising salvage option for this “no-option” patient population, due to the small artery disease. However, there are subgroups of these patients that do not even have an option for EVVA. We report a case of an early 70s female patient of successful lower extremity limb salvage with a history of “full metal jacket” peripheral arterial stenting, utilizing superficial venous arterialization technique, in a patient with a refractory deep plantar ulcer and prior transmetatarsal amputation of the left foot. The patient healed within 5 weeks and maintained the ambulatory status, supporting the expanding role of venous arterialization technique variations in complex no-option CLTI.