There is not enough evidence about how well this procedure works or how safe it is. So, for people who have limited treatment options, it can only be done with special arrangements. This means you will have regular appointments after the procedure to check how well it is working or if it has caused problems.
Chronic limb-threatening ischaemia happens when blocked arteries reduce blood flow to a limb (usually the leg). Symptoms include pain and ulcers. In severe cases the tissue dies because of the lack of blood supply and there is a high risk of losing the limb.
In this procedure, under general anaesthesia, 2 small tubes are inserted through the skin (percutaneous) and moved into the target artery and vein, deep in the leg. A needle is used to create a hole to allow blood to flow from the artery into the vein, into the part of the leg beyond the blockage (venous arterialisation). The valves inside the vein are removed, and stents (short, wire mesh tubes that act like a scaffold) are placed to keep the hole working. The aim is to improve symptoms and preserve the affected limb by restoring blood flow.
Is this procedure right for me?
You should be included in making decisions about your care.
Your healthcare professionals should explain the risks and benefits of this procedure and how it is done. They should discuss your options and listen carefully to your views and concerns. They should offer you more information about the procedure. Your family or carers can be involved if you want or need them to be.
You will be asked to decide whether you agree (consent) to have the procedure. Find out more about giving consent to treatment on the NHS website.
Some questions to think about
- How many appointments will I need?
- What are the possible benefits? How likely am I to get them?
- What are the risks or side effects? How likely are they?
- Will I have to stay in hospital?
- What happens if it does not work or something goes wrong?
- What happens if I do not want the procedure?
- Are other treatments available?
Information and support
The NHS webpage on peripheral arterial disease may be a good place to find out more.
You can search the NHS website for information about consultants and hospitals that offer this procedure.
- NICE's information on interventional procedures guidance explains what an interventional procedure is and how we assess it.
- NICE’s information on interventional procedures recommendations explains what special arrangements are.
These organisations can give you advice and support:
You can also get support from your local Healthwatch.
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