CASE REPORT

Chronic limb-threatening ischemia, successful infra popliteal endovascular revascularization: a case report

Dawar Sitaba Kleruk , Yopie Afriandi Habibie

Dawar Sitaba Kleruk
Surgery Resident, Department of Surgery, Faculty of Medicine Universitas Syiah Kuala, The Zainoel Abidin General Hospital, Banda Aceh, Indonesia.. Email: [email protected]

Yopie Afriandi Habibie
Division of Thoracic Cardiac and Vascular Surgery, Department of Surgery, Faculty of Medicine, Universitas Syiah Kuala, The Dr. Zainoel Abidin General Hospital, Banda Aceh, Indonesia
Online First: August 04, 2021 | Cite this Article
Kleruk, D., Habibie, Y. 2021. Chronic limb-threatening ischemia, successful infra popliteal endovascular revascularization: a case report. Bali Medical Journal 10(2): 692-695. DOI:10.15562/bmj.v10i2.2333


Introduction: Chronic limb-threatening ischemia (CLTI), a manifestation of peripheral arterial disease (PAD) that is characterized by chronic ischemic pain in the foot, inadequate tissue perfusion at rest more than 2 weeks, non-healing wounds, or gangrene that is attributable to objectively proven arterial occlusive disease. Endovascular surgery has played an important rules for revascularization in limb saving.

Case description: 57-years-old man came to the Zainoel Abidin General Hospital emergency room, with a chief complaint of ischemic pain at the right foot since 3 months ago, and being extremely progressive for 10 days. He has no history of smoking and 10-year history of controlled type 2 diabetes mellitus. On the physical examination revealed a stable hemodynamic, an unhealed wound in the right lower limb as well as an open wound size 10cm x 6cm x 4cm. He has palpable femoral pulses but not distal pulses. Peripheral CT angiography obtained a total occlusion at the right anterior tibialis artery (ATA), and no flows at the right dorsalis pedis artery (DPA). Performed a revascularization procedure with endovascular therapy using 3 mm balloon angioplasty with good results along the ATA and DPA. The patient was discharged on the 4th day after surgery. Clinical Evaluation after 2 months showed improvement on pain, good ulcer healing and ready for skin grafting.

Conclusion: The goal of treatment for CLTI is to relieve pain, heal wounds, and preserve a functional limb, with a cornerstone of treatment is timely arterial revascularization Endovascular surgery in one of the best revascularization techniques for CLTI.

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