A New Hope for Patients Facing Leg Amputation

For some patients with severe forms of poor circulation in their legs, conventional treatments simply run out of options. These are people whose arteries — the blood vessels that carry oxygen-rich blood to the feet — have become so blocked that neither surgery nor keyhole procedures can restore blood flow. Without intervention, the outlook is bleak: up to 40% face the loss of a limb within six months. Until recently, this group of patients, often referred to as having "no-option" critical limb ischaemia, had very little left to offer them beyond pain management and, ultimately, amputation.

A promising treatment called percutaneous deep venous arterialization (pDVA), using a device known as the LimFlow system, offers a completely different approach. Instead of trying to repair the blocked arteries, the procedure redirects oxygen-rich blood through the veins in the foot — essentially teaching the body's own vein network to do the job the arteries can no longer perform. The technique is carried out through small punctures in the skin, without the need for open surgery, and takes around two and a half hours. The body then gradually adapts, and new blood vessel growth is stimulated in the affected foot.

Our team at Guy's and St Thomas' NHS Foundation Trust in London has now published the results of 34 patients who underwent this procedure between 2020 and 2024, with some patients followed for up to five years. The results are encouraging: the procedure was technically successful in every single case. After two years, almost 89% of patients kept their leg, 72% were alive and free from major amputation, and two-thirds achieved complete wound healing — with wounds typically healing within nine months. Only four patients ultimately required a major amputation below the knee.

These findings add to the growing international evidence that the LimFlow system can offer a genuine lifeline to patients who would previously have had no surgical options. Recovery does require patience — the healing process can take several months, and close follow-up with regular scans is an essential part of the journey to detect and treat any narrowing early. The results depend heavily on careful patient selection, close monitoring after the procedure, and a dedicated team approach involving surgeons, radiologists, podiatrists, and wound care specialists. If you or someone you know has been told that nothing more can be done for poor circulation in the legs, it may be worth asking whether this treatment could be suitable.

Based on: Morshed AM, Thulasidasan N, Nair H, Diamantopoulos A, Patel S, Zayed H. "Mid-Term Outcomes of Percutaneous Deep Venous Arterialization Using the LimFlow System." Journal of Endovascular Therapy, 2026.

If you or someone you know experience features of poor circulation, it is advisable to contact your doctor for a consultation and advice on management options. The above information is not a substitute for clinical assessment by a qualified healthcare professional.