PMID- 37303628
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230613
IS  - 1943-8141 (Print)
IS  - 1943-8141 (Electronic)
IS  - 1943-8141 (Linking)
VI  - 15
IP  - 5
DP  - 2023
TI  - Periosteal distraction for foot preservation contributes to favorable clinical 
      effects and prognosis in a foot ulcer patient with critical limb ischemia after 
      multiple operations.
PG  - 3766-3772
AB  - This paper presents the challenges faced by a patient undergoing limb-sparing 
      treatment due to chronic limb-threatening ischemia (CLTI) complicated with 
      long-standing nonhealing foot ulcer and intense pain. However, after multiple 
      vascular surgeries, the foot wound continued to worsen, which could lead to 
      transfemoral amputation and even death. We report a case of an aged male patient 
      admitted after complaining of "pain and ulceration in his left foot for ten 
      months". The patient was diagnosed with arteriosclerosis obliterans of the lower 
      limbs with critical limb ischemia, which improved little after the drug therapy. 
      This patient had undergone three endovascular procedures with a medical history 
      of myocardial infarction and stenting. The main artery could not be directly 
      connected to the foot by open or endovascular surgery due to severe vascular 
      occlusion below the knee. In addition, foot ulcers made it impossible to walk, 
      which induced angina pectoris. After coordination and discussion, we determined 
      to perform a 2-week lateral tibial periosteum distraction (LTPD). The procedure 
      significantly improved the foot wound and relieved the pain. After the two-week 
      personalized wound management, the wound healed, and the pain disappeared. 
      Consequently, the patient was able to walk independently, without recurrence 
      during the 3-month follow-up period. Periosteal distraction has rarely been 
      reported in previous literature and is mainly used to treat patients with 
      diabetic foot, rather than those who have undergone repeated percutaneous 
      transluminal angioplasty (PTA) for CLTI combined with foot ulcers. As most CLTI 
      patients are suffering from cardiac, cerebral, and renal diseases, their blood 
      vessels are difficult to open, with high re-occlusion and recurrence rates and 
      low limb salvage rate. Therefore, we present our case herein so that the CLTI 
      patients whose inferior genicular arteries cannot be opened due to severe 
      infrapopliteal arterial occlusion complicated with nonhealing foot ulcers or 
      intractable pain can be treated with LTPD, thus providing them with the "last 
      kilometer" bloodstream towards the foot.
CI  - AJTR Copyright (c) 2023.
FAU - Wang, Jinjun
AU  - Wang J
AD  - Qingdao Haici Hospital Affiliated to Qingdao University (Qingdao TCM Hospital) 
      Qingdao 266033, Shandong, PR China.
FAU - Huang, Xianming
AU  - Huang X
AD  - Qingdao Haici Hospital Affiliated to Qingdao University (Qingdao TCM Hospital) 
      Qingdao 266033, Shandong, PR China.
FAU - Wang, Pinyi
AU  - Wang P
AD  - Qingdao Haici Hospital Affiliated to Qingdao University (Qingdao TCM Hospital) 
      Qingdao 266033, Shandong, PR China.
FAU - Zhang, Juanzi
AU  - Zhang J
AD  - Qingdao Haici Hospital Affiliated to Qingdao University (Qingdao TCM Hospital) 
      Qingdao 266033, Shandong, PR China.
FAU - Yu, Yuanyuan
AU  - Yu Y
AD  - Qingdao Haici Hospital Affiliated to Qingdao University (Qingdao TCM Hospital) 
      Qingdao 266033, Shandong, PR China.
FAU - Chen, Xiguang
AU  - Chen X
AD  - College of Marine Life Science, Ocean University of China Qingdao 266003, 
      Shandong, PR China.
LA  - eng
PT  - Case Reports
DEP - 20230515
PL  - United States
TA  - Am J Transl Res
JT  - American journal of translational research
JID - 101493030
PMC - PMC10251005
OTO - NOTNLM
OT  - Chronic limb-threatening ischemia
OT  - lateral tibial periosteum distraction
OT  - percutaneous transluminal angioplasty
OT  - peripheral artery diseases
COIS- None.
EDAT- 2023/06/12 06:42
MHDA- 2023/06/12 06:43
PMCR- 2023/05/15
CRDT- 2023/06/12 03:56
PHST- 2023/03/09 00:00 [received]
PHST- 2023/04/24 00:00 [accepted]
PHST- 2023/06/12 06:43 [medline]
PHST- 2023/06/12 06:42 [pubmed]
PHST- 2023/06/12 03:56 [entrez]
PHST- 2023/05/15 00:00 [pmc-release]
PST - epublish
SO  - Am J Transl Res. 2023 May 15;15(5):3766-3772. eCollection 2023.