BACKGROUND 79.4% diabetic) were included, with a median follow-up of 21 months (4-62 months). Technical success was 100%. At 24 months, AFS was 72% and LS was 88.6%. Full wound healing was achieved in 66% of patients, with a median time of 262 days from the index procedure. Kaplan-Meier analysis showed 24-month PP and SP rates of 46.3% and 76%, respectively. Freedom from reintervention was 58% at 24 months. Four major amputations (11.7%) were required. CONCLUSION: Percutaneous deep venous arterialization using the LimFlow system provides acceptable mid-term outcomes. Satisfactory AFS, LS, PP, SP and wound healing rates were achieved in these no-option CLTI options. Strict post-procedure surveillance and reintervention protocols are essential to maintain satisfactory outcomes.Clinical ImpactThe LimFlow system introduces a novel option for patients with no revascularization alternatives. It enables limb salvage in severe CLTI cases previously destined for amputation. By creating arterial flow through the venous system, it redefines vascular intervention strategies. Clinicians gain a new tool for "no-option" patients, expanding treatment eligibility. This may reduce major amputation rates and improve quality of life. The approach requires new technical skills and multidisciplinary collaboration. It shifts practice toward advanced endovascular innovation rather than palliative care. Patient selection and procedural expertise become critical for success. The study highlights the feasibility and safety of transcatheter arterialization. Overall, it represents a paradigm shift in managing advanced peripheral artery disease.
Morshed et al. (Mon,) studied this question.
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