The objective of the study is to evaluate early safety and effectiveness of the percutaneous deep foot venous arterialization performed in clinical practice, in an unselected population of patients with "no-option" CLTI.
Critical lower Limb Threatening Ischemia is the most advanced stage of lower limb arterial disease and is associated with a high risk of mortality and major amputation.Literature data indicate that about 5-10% of patients with peripheral arterial disease have a risk of developing CLTI, therefore the most advanced stage of arterial disease of the lower limbs, within 5 years and have a mortality of 20% at 6 months after diagnosis of CLTI.Despite the continuous improvement of the techniques and materials used in the revascularization of these patients, the data of the Literature show that in about 10-15% of these patients revascularization is impossible or ineffective. This condition is defined as: "no-option" CLTI.Therefore, for patients with "no-option" CLTI an alternative treatment for limb rescue may be considered the use of arterialization of the venous plexus of the foot; that is, to use to bring the arterial flow to the foot a healthy conduit, such as the vein, instead of the diseased artery and no longer usable. The present study is designed as a multicentre, prospective, single-arm, observational study. All eligible subjects for undergoing PiPER procedure at sites participating in the study will be considered for enrolment and will be asked to give consent prior to participating. Subjects will be considered enrolled in the study at the time written informed consent is given to the use of their personal data. Once patients are enrolled, their demographics, medical history, disease-relevant conditions, treatment details and outcomes will be collected for up to 24 months from the procedure. The study will collect information about the medical care patients receive during their planned procedure. No additional testing or procedures will be done. The revascularization procedure will be performed as per the current clinical practice. After discharge all patients will attend clinic visits at 30 days (±7 days), 6 months (±14 days),12 months (±30 days), 24 months (±30 days).
Study Type
OBSERVATIONAL
Enrollment
50
Irccs Inrca
Ancona, Ancona, Italy
RECRUITINGOspedale San Martino
Belluno, Italy, Italy
RECRUITINGOspedale Bufalini
Cesena, Italy, Italy
Safety Composite
Composite of amputation free survival, defined as the rate of limb salvage (freedom from major amputation) and survival (freedom from all causes of death) of the percutaneous deep foot venous arterialization procedure.
Time frame: 30 days, 6 months
Procedural Success
Procedural success (defined as completion of the procedure by percutaneous route with achievement of arterial flow in the venous plexus of the foot at the end, as angiographically assessed);
Time frame: Day 1
Primary Patency
Primary patency defined as no occlusion of the arterialized vein tract
Time frame: 30 days, 3 months, 6 months, 12 months and 24 months
Secondary Patency
Secondary patency defined as no secondary occlusion of the arterialised vein tract
Time frame: 30 days, 3 months, 6 months, 12 months and 24 months
A-V fistula flow rate
A-V fistula flow rate
Time frame: 30 days, 3 months, 6 months, 12 months and 24 months
Minor amputation rates
Minor amputation rates defined as a below the ankle amputation
Time frame: 30 days, 3 months, 6 months, 12 months and 24 months
Major amputation rates
Major amputation rates defined as an above the ankle amputation
Time frame: 30 days, 3 months, 6 months, 12 months and 24 months
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Ospedale di Conegliano - USLL2
Conegliano, Italy, Italy
WITHDRAWNOspedale Cardarelli
Naples, Italy, Italy
RECRUITINGArcispedale Santa Maria Nuova
Reggio Emilia, Italy, Italy
WITHDRAWNOspedale Santa Chiara
Trento, Italy, Italy
RECRUITINGAzienda Ospedaliera S. Maria della Misericordia
Perugia, Perugia, Italy
NOT_YET_RECRUITINGOspedale Pederzoli
Peschiera del Garda, Veneto, Italy
RECRUITINGRe-Treatment rate
Re-Treatment rate defined as need for reintervention
Time frame: 30 days, 3 months, 6 months, 12 months and 24 months
Wound Size
Wound Size defined as wound size reduction index
Time frame: Baseline, 30 days, 3 months, 6 months, 12 months and 24 months
TpcO2
TpcO2 defined as TpcO2 value changes
Time frame: Baseline, 30 days, 3 months, 6 months, 12 months and 24 months
WIFi class
WIFi class and stage changes
Time frame: Baseline, 30 days, 3 months, 6 months, 12 months and 24 months
Freedom from all cause death
Freedom from all cause death
Time frame: 30 days, 3 months, 6 months, 12 months and 24 months
Freedom from procedure-related death
Freedom from procedure-related death
Time frame: 30 days, 3 months
Rutherford class
Rutherford class and stage changes
Time frame: Baseline, 30 days, 3 months, 6 months, 12 months and 24 months