Novel combination therapy of pedal arch angioplasty and dual distal bypass as an alternative treatment option for vasculitis in patients with chronic limb-threatening ischemia

Nobuko Yamamoto, MD, PhD; Hiroyoshi Komai, MD, PhD; Hideki Sakashita, MD, PhD; Noriyuki Miyama, MD, PhD; Daizo Kawasaki, MD, PhD; Masashi Fukunaga, MD

Journal of Vascular Surgery Cases and Innovative Techniques (Jun 2023)

Novel combination therapy of pedal arch angioplasty and dual distal bypass as an alternative treatment option for vasculitis in patients with chronic limb-threatening ischemia

Nobuko Yamamoto, MD, PhD,
Hiroyoshi Komai, MD, PhD,
Hideki Sakashita, MD, PhD,
Noriyuki Miyama, MD, PhD,
Daizo Kawasaki, MD, PhD,
Masashi Fukunaga, MD

Affiliations

Nobuko Yamamoto, MD, PhD: Department of Vascular Surgery, Kansai Medical University Medical Center, Osaka, Japan; Correspondence: Nobuko Yamamoto, MD, PhD, Department of Vascular Surgery, Kansai Medical University Medical Center, 10-15 Fumizonocho, Moriguchi, Osaka 570-8507, Japan
Hiroyoshi Komai, MD, PhD: Department of Vascular Surgery, Kansai Medical University Medical Center, Osaka, Japan
Hideki Sakashita, MD, PhD: Department of Vascular Surgery, Kansai Medical University Medical Center, Osaka, Japan
Noriyuki Miyama, MD, PhD: Department of Vascular Surgery, Kansai Medical University Medical Center, Osaka, Japan
Daizo Kawasaki, MD, PhD: Department of Cardiology, Morinomiya Hospital, Osaka, Japan
Masashi Fukunaga, MD: Department of Cardiology, Morinomiya Hospital, Osaka, Japan

Journal volume & issue: Vol. 9, no. 2
p. 101138

Abstract

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A 68-year-old man with chronic limb-threatening ischemia caused by atypical vasculitis was successfully treated by the combination of pedal arch angioplasty and dual distal bypass. Angioplasty alone failed; therefore, we performed pedal arch angioplasty followed by distal bypass revascularized to the newly created dorsalis pedis artery and posterior tibial artery anastomosis sites. Restenosis occurred twice, and both cases were successfully treated by immediate angioplasty. Both branches of the graft remained patent for >2.5 years, and the wound healed completely. This unique combination of techniques can provide favorable results for selected patients with chronic limb-threatening ischemia.

Published in Journal of Vascular Surgery Cases and Innovative Techniques

ISSN: 2468-4287 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Surgery; Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.sciencedirect.com/journal/journal-of-vascular-surgery-cases-innovations-and-techniques

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