PMC9850122_01
(a) The wound before treatment (30 x 30 mm). (b) Angiography images before
treatment. (c) Angiography images presenting occlusion after surgery (white
arrow). (d) The wound after Rheocarna  therapy (20 x 5 mm). (e)
Angiography images after endovascular treatment. (f) The wound after
endovascular treatment.
10.1177_2050313X221149359-fig2.jpg
PMC9850122_01_10.1177_2050313X221149359-fig2.jpg
fig2-2050313X221149359
A 65-year-old Asian man who underwent hemodialysis for chronic glomerular nephritis at 39 years of age was referred to our hospital for an ulcer on his right heel (Figure 2(a)). Pre-treatment right lower extremity angiography showed chronic total occlusions with severe calcification in the anterior tibial, peroneal (PA), and posterior tibial arteries (Figure 2(b)). However, the bypass was occluded during the early postoperative period (Figure 2(c)). The patient's ulcer gradually and significantly improved over 2 months (Figure 2(d)), the ulcer was reduced from 30 x 30 mm to 20 x 5 mm, and plantar SPP improved from 21 mmHg to 31 mmHg. Eventually, EVT with plain balloon angioplasty was successfully performed on the occluded bypass graft (Figure 2(e)), and the ulcer resolved 1 month later (Figure 2(f)).