Peripheral Extreme Revascularization in "No-option" Patiens With Chronic Limb Threatening Ischemia

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).

• Procedural Success [Срок оценки: Day 1]
• Primary Patency [Срок оценки: 30 days, 3 months, 6 months, 12 months and 24 months]
• Secondary Patency [Срок оценки: 30 days, 3 months, 6 months, 12 months and 24 months]
• A-V fistula flow rate [Срок оценки: 30 days, 3 months, 6 months, 12 months and 24 months]
• Minor amputation rates [Срок оценки: 30 days, 3 months, 6 months, 12 months and 24 months]
• Major amputation rates [Срок оценки: 30 days, 3 months, 6 months, 12 months and 24 months]
• Re-Treatment rate [Срок оценки: 30 days, 3 months, 6 months, 12 months and 24 months]
• Wound Size [Срок оценки: Baseline, 30 days, 3 months, 6 months, 12 months and 24 months]
• TpcO2 [Срок оценки: Baseline, 30 days, 3 months, 6 months, 12 months and 24 months]
• WIFi class [Срок оценки: Baseline, 30 days, 3 months, 6 months, 12 months and 24 months]
• Freedom from all cause death [Срок оценки: 30 days, 3 months, 6 months, 12 months and 24 months]
• Freedom from procedure-related death [Срок оценки: 30 days, 3 months]