Clinical Study

Our Treatment Strategy for Critical Limb Ischemia

Figure 3

(a) Findings at first visiting our hospital: gangrene of the left 4th toe and skin necrosis of the lateral foot were observed. (b) Angiographic findings of the leg (left: before EVT; right: after EVT): occlusion of the left posterior tibial artery and stenosis of the anterior tibial artery and peroneal artery were observed; therefore, the 3 branches were dilated with a balloon. (c) Findings immediately after amputation of the left 4th toe and debridement: the left 4th toe was amputated at the metatarsal shaft, and skin necrosis of the lateral foot was removed. (d) Finding at the end of NPWT treatment using the V.A.C. ATS therapy system was performed for 3 weeks, and granulation was observed. (e) Finding immediately after split-thickness skin grafting: a skin graft with PRP (platelet-concentration ratio: 5.1x) was performed. (f) Finding at 2.5 months after the treatment.
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(a)
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(c)
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(d)
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(e)
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(f)