JACC

Lots of interesting abstracts and cases were submitted for TCTAP 2022. Below are the accepted ones after a thorough review by our official reviewers. Don¡¯t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!

TCTAP C-147

The Endovascular Treatment of Chronic Limbs Threatening Ischemia in a Patient With Spinal Cord Injury

By Je Hyung Park, Dong Hyun Kim, Jin-Ho Mun, Sang-Su Lee

Presenter

Je Hyung Park

Authors

Je Hyung Park1, Dong Hyun Kim1, Jin-Ho Mun1, Sang-Su Lee1

Affiliation

Pusan National University Yangsan Hospital, Korea (Republic of)1,
View Study Report
TCTAP C-147
ENDOVASCULAR - Peripheral Vascular Disease and Intervention

The Endovascular Treatment of Chronic Limbs Threatening Ischemia in a Patient With Spinal Cord Injury

Je Hyung Park1, Dong Hyun Kim1, Jin-Ho Mun1, Sang-Su Lee1

Pusan National University Yangsan Hospital, Korea (Republic of)1,

Clinical Information

Patient initials or Identifier Number

CCL

Relevant Clinical History and Physical Exam

This case is a 69-year-old patient with spinal cord injury and paralysis on both sides due to an accident that occurred while working at a factory 30 years ago. He was bedridden after the onset of paralysis and developed metabolic syndromes such as high blood pressure, diabetes, and hyperlipidemia.
A pressure sore on the right ankle has occurred since 3 years ago, and plastic surgery continued to treat it, but the wound did not improve.


Relevant Test Results Prior to Catheterization

The preoperative ABI was as low as 0.2 in the right lower extremity and 0.3 in the left lower extremity.
In the CT angiography, the diameter of peripheral artery in both lower extremities was generally too small, and diffuse calcification was observed. In particular, the middle part of the right superficial femoral artery was occluded.

Relevant Catheterization Findings

Stenosis of the right iliac artery was confirmed during intraoperative angiography.
The middle part of right superficial femoral artery was occluded.

Interventional Management

Procedural Step

Right common femoral artery cut-down because of endarterectomy.Right iliac artery had multifocal stenosis  Balloon angioplasty performed with 6 mm x 15 cm balloon (Admiral, Medtronic, Santa Rosa, Califonia) at stenotic lesionmid part of right superficial femoral artery had total occlusion  Preballoon was performed with 3-3.5 mm tapered balloon (Amphirion, Medtronic, Santa Rosa, Califonia)   --> Drug coated balloon angioplasty performed 4 mm x 150 mm drug coated balloon (IN.PACT Admiral, Medtronic, Santa Rosa, Califonia)





Case Summary

Spinal cord injury (SCI) patients are known to have a significantly higher risk of developing PAD than those without SCI.
Pressure ulcers in people with SCI are taken for granted and are not treated appropriately.
If the healing of pressure sores is delayed, peripheral arterial disease should be suspected and appropriate treatment should be initiated.