Angiosome concept in the real world scenario ... · Angiosome concept in the real world scenario...

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Angiosome concept in the real world scenario --- presentation and a case example I-Ming Chen, MD, PhD 2015 SVS International Scholar Assistant Professor, Yang-Ming University, Taiwan Attending Surgeon, Taipei Veterans General Hospital

Transcript of Angiosome concept in the real world scenario ... · Angiosome concept in the real world scenario...

Page 1: Angiosome concept in the real world scenario ... · Angiosome concept in the real world scenario ---presentation and a case example I-Ming Chen, MD, PhD 2015 SVS International Scholar

Angiosome concept in the real world scenario ---

presentation and a case example

I-Ming Chen, MD, PhD

2015 SVS International Scholar

Assistant Professor, Yang-Ming University, Taiwan

Attending Surgeon, Taipei Veterans General Hospital

Page 2: Angiosome concept in the real world scenario ... · Angiosome concept in the real world scenario ---presentation and a case example I-Ming Chen, MD, PhD 2015 SVS International Scholar

Disclosure

Speaker name:

.................................................................................

I have the following potential conflicts of interest to report:

Consulting

Employment in industry

Stockholder of a healthcare company

Owner of a healthcare company

Other(s)

v I do not have any potential conflict of interest

Disclosure

Speaker name:

.................................................................................

I have the following potential conflicts of interest to report:

Consulting

Employment in industry

Stockholder of a healthcare company

Owner of a healthcare company

Other(s)

v I do not have any potential conflict of interest

Page 3: Angiosome concept in the real world scenario ... · Angiosome concept in the real world scenario ---presentation and a case example I-Ming Chen, MD, PhD 2015 SVS International Scholar

Concept of BTK angiosome in revascularization & limb salvage

Plast. Reconstr. Surg. 117 (Suppl.): 261S, 2006.

Page 4: Angiosome concept in the real world scenario ... · Angiosome concept in the real world scenario ---presentation and a case example I-Ming Chen, MD, PhD 2015 SVS International Scholar

Case presentation

81 y/o male

R’t big toe gangrene, RC 6

HTN, hyperlipidemia

T2DM under medication

s/p CABG for 10 years

Page 5: Angiosome concept in the real world scenario ... · Angiosome concept in the real world scenario ---presentation and a case example I-Ming Chen, MD, PhD 2015 SVS International Scholar
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Procedure plan

Antegrade approach: 5 French sheath

Wiring ATA, retrograde when antegrade fails

SAFARI then DCB PTA (Ranger DCB)

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Page 8: Angiosome concept in the real world scenario ... · Angiosome concept in the real world scenario ---presentation and a case example I-Ming Chen, MD, PhD 2015 SVS International Scholar
Page 9: Angiosome concept in the real world scenario ... · Angiosome concept in the real world scenario ---presentation and a case example I-Ming Chen, MD, PhD 2015 SVS International Scholar

BTK retrograde approach

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Key for success BTK retrograde punctureRotate C-arm correctly

Left leg--- ATA/DPA LAO 20~450 (+/- cranial 200) --- PTA RAO 60~800

--- PA LAO 30~450

Right leg--- ATA/DPA RAO 20~450 (+/- cranial 200) --- PTA LAO 60~800

--- PA RAO 30~450

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Tube-artery-needle in a single line

Page 12: Angiosome concept in the real world scenario ... · Angiosome concept in the real world scenario ---presentation and a case example I-Ming Chen, MD, PhD 2015 SVS International Scholar
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Take Home Message

Multi-discipline management is mandatory.

Angiosome-based revascularization.

Familiar with retrograde puncture and SAFARI.

Page 14: Angiosome concept in the real world scenario ... · Angiosome concept in the real world scenario ---presentation and a case example I-Ming Chen, MD, PhD 2015 SVS International Scholar

Conclusion

Thanks for your attention!

Multi-discipline management is mandatory.

Angiosome-based revascularization.

Familiar with retrograde puncture and SAFARI.