2005 Symposium on Advanced Wound Care | |
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Case Study
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Advanced revascularization techniques combined with bi-layered cell therapy in critical limb ischemia David E. Allie, MD, Chris J. Hebert, RT, RCIS, Craig M. Walker, MD, Cardiovascular Institute of the South/Lafayette, Lafayette, LA Major amputation rates for the lower extremity are reported as > 90% if non-revascularable and 25% if revascularable at 12 months. Twenty-four month mortality rates of > 40-50% are reported post amputation. Adoption of excimer laser assisted angioplasty is one our primary infrapopliteal treatments for true limb salvage. We report a case utilizing advanced revascularization procedures combined the use of a bi-layered cell therapy* for the treatment of critical limb ischemia. The bi-layered cell therapy expresses multiple growth factors found in normal skin, and provides a biologically active matrix; it is approved for both venous leg ulcers and diabetic foot ulcers. A 69-year-old male with diabetes presented with an ischemic left foot and eschar of the left ankle and heel. Angiography revealed severe infrapopliteal disease with no flow to the foot. A 0.014’ coronary wire was used across the occluded posterior tibial artery and into a tarsal vessel followed by a 0.9 mm laser catheter. Post-procedure, straight-line flow was restored to the foot. The eschar was debrided 24-hours later and the bi-layered cell therapy was applied, healing occurred at day 48. Laser endovascular therapy combined with bi-layered cell therapy is a vital tool when facing limb salvage. * Apligraf® is a registered trademark of Novartis, Inc., East Hanover, NJ © 2004 Organogenesis, Inc., Canton, MA |
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