Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2025 Aug 22;16(8):318-322.
doi: 10.14740/jmc5155. eCollection 2025 Aug.

Transcatheter Arterialization of the Deep Veins for Chronic Limb-Threatening Ischemia: A Case Series of the Direct Cost Associated With Limb Salvage

Aldin Malkoc  1 , Xinfei Miao  2 , Lana Mamoun  2 , Catherine Lai  2 , Raja GnanaDev  1 , Michelle Lee  1 , Samuel Lee  1   2 , Samuel Schwartz  1   2
Affiliations
Case Reports

Transcatheter Arterialization of the Deep Veins for Chronic Limb-Threatening Ischemia: A Case Series of the Direct Cost Associated With Limb Salvage

Aldin Malkoc et al. J Med Cases. .

Abstract

Our study aims to estimate the long-term cost of procedurally successful transcatheter arterialization of the deep veins (TADV) coupled with adjunct therapy. Patients with no conventional endovascular/open options were considered for TADV. TADV index procedure cost, cost of subsequent procedures and wound care/adjuncts were collected. Cost data were obtained from Medicare claims and other published sources. All patients in the study had limb salvage 180 days after TADV. Success was defined as lime salvage with no more than a transmetatarsal amputation of the affected limb. The average cost of the procedure was $320,850. The average hospital cost (hospitalization and wound care adjuncts) was $895,546. The overall average total cost was $1,216,396. TADV and associated multidisciplinary wound care approach for "no option" chronic limb-threatening ischemia does not appear to be a cost-effective strategy, with an average total cost of over 1 million dollars per patient.

Keywords: Amputation; Cost; Deep venous arterialization; Limb salvage; Medicare; Transcatheter arterialization of the deep veins.

PubMed Disclaimer

Conflict of interest statement

None to declare.

Similar articles

See all similar articles

References

    1. Allison MA, Ho E, Denenberg JO, Langer RD, Newman AB, Fabsitz RR, Criqui MH. Ethnic-specific prevalence of peripheral arterial disease in the United States. Am J Prev Med. 2007;32(4):328–333. doi: 10.1016/j.amepre.2006.12.010. - DOI - PubMed
    1. Nehler MR, Duval S, Diao L, Annex BH, Hiatt WR, Rogers K, Zakharyan A. et al. Epidemiology of peripheral arterial disease and critical limb ischemia in an insured national population. J Vasc Surg. 2014;60(3):686–695.e682. doi: 10.1016/j.jvs.2014.03.290. - DOI - PubMed
    1. Abu Dabrh AM, Steffen MW, Undavalli C, Asi N, Wang Z, Elamin MB, Conte MS. et al. The natural history of untreated severe or critical limb ischemia. J Vasc Surg. 2015;62(6):1642–1651.e1643. doi: 10.1016/j.jvs.2015.07.065. - DOI - PubMed
    1. Ilyas S, Powell RJ. Management of the no-option foot: Deep vein arterialization. Semin Vasc Surg. 2022;35(2):210–218. doi: 10.1053/j.semvascsurg.2022.05.002. - DOI - PubMed
    1. Hardman RL, Jazaeri O, Yi J, Smith M, Gupta R. Overview of classification systems in peripheral artery disease. Semin Intervent Radiol. 2014;31(4):378–388. doi: 10.1055/s-0034-1393976. - DOI - PMC - PubMed

Publication types

LinkOut - more resources