Atheroplasty - Proof of Mechanism, First in Human

Revascularization of Critical Limb Ischemia

86-year-old female with non-healing ischemic ulcers on toes at risk of amputation (Rutherford Category 6)

Critical Limb Ischemia

Case courtesy of Drs. Ebner and Ramaiah

Professor Adrian Ebner

Professor Adrian Ebner, based in Paraguay, is the Head of the Cardiovascular Department at Sanatorio Italiano, Asuncion, Paraguay.

Dr. Venkatesh Ramaiah

Dr. Venkatesh Ramaiah

Dr. Venkatesh Ramaiah was formerly the Chief of Complex Vascular Services for the HonorHealth hospital system. He is the founder of Pulse Cardiovascular Institute, the first cardiovascular outpatient surgery center in Scottsdale, Arizona.

Patient History

86-year-old female with a history of hypertension, coronary artery disease, non-diabetic, and non-smoker

  • Rest pain for several months with non-healing ischemic ulcers on toes
  • Very poor distal runoff
Baseline
Baseline ischemic foot with non-healing toe ulcers

Procedural Information

Mid Superficial Femoral Artery (SFA) Chronic Total Occlusion (CTO)

CTO Length
140mm

Atheroplasty was used in an antegrade intraluminal crossing approach.

Crossing Time
10 min

Revascularization post Atheroplasty

Mid Superficial Femoral Artery (SFA) Chronic Total Occlusion (CTO)

IVUS showing intraluminal SFA crossing and 68% lumen gain, no loose plaque, and no distal vessel embolism

IVUS showing Intraluminal SFA Crossing

Final Result

Final angiogram post PTA and SFA stenting with improved flow

Quality of Life Improved

6 months post procedure
Ischemic ulcers healed, no amputation, no complaints of pain, and patient was able to walk again

Healed ischemic foot six months after the procedure