Darwin Eton, MD, Hong Yu, PhD Journal of Vascular Surgery

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Presentation transcript:

Enhanced cell therapy strategy to treat chronic limb-threatening ischemia Darwin Eton, MD, Hong Yu, PhD Journal of Vascular Surgery Volume 52, Issue 1, Pages 199-204 (July 2010) DOI: 10.1016/j.jvs.2009.12.048 Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 1 Patient 1 serial images of transmetatarsal wound. A, One month after angioplasty of femoral-peroneal graft angioplasty occluded and outflow embolized. B, Six weeks after panel A, granulation tissue beginning to form after wound completely opened. C, Wound healed after 5 months using the ArtAssist Device and 10 granulocyte-colony stimulation factor (G-CSF) injections in the first month. Journal of Vascular Surgery 2010 52, 199-204DOI: (10.1016/j.jvs.2009.12.048) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 2 Patient 1 pulse volume recordings. A, Ankle brachial index (ABI) was 0 (September 25, 2009), and there was no pulsatility at the ankle level prior to enrollment. B, ABI = 0.43 on April 8, 2009, and pulsatility returned at the left ankle. C, ABI = 0.64 on June 3, 2009. Journal of Vascular Surgery 2010 52, 199-204DOI: (10.1016/j.jvs.2009.12.048) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 3 Patient 1 angiography. Panels A to D were obtained on initial referral. Panels E to H were obtained at 6-month follow-up. Note the increased collateral vessels at all levels from above the knee (E vs A), below the knee (F vs B), the calf (G vs C), and the ankle (H vs D). Journal of Vascular Surgery 2010 52, 199-204DOI: (10.1016/j.jvs.2009.12.048) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 4 Patient 2 exposed Achilles' tendon. A, On presentation. B, Five months later. C, One year after presentation. Journal of Vascular Surgery 2010 52, 199-204DOI: (10.1016/j.jvs.2009.12.048) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 5 Patient 2 pulse volume recordings (PVR). A, Prior to enrollment, no pulsatility was recorded on PVR at the transmetatarsal level (September 18, 2008), at which time her ankle brachial index (ABI) was 0.43. B, ABI = 0.53 on January 8, 2009. C, ABI = 0.58 on April 8, 2009. D, Return of pulsatility was seen at the transmetatarsal level on August 17, 2009, at which time her ABI was 0.64, confirmed in the November 18, 2009 PVR shown, confirmed in the November 18, 2009 PVR shown. Journal of Vascular Surgery 2010 52, 199-204DOI: (10.1016/j.jvs.2009.12.048) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 6 Patient 2 photoplethysmography documents absence of pulsatility in the toes until November 2009, when pusatility was recorded for the first time in the first toe. Journal of Vascular Surgery 2010 52, 199-204DOI: (10.1016/j.jvs.2009.12.048) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 7 Patient 2 angiography. Panels A to E were obtained on initial referral: panel A is femoral; panel B is above-the-knee popliteal; panel C is below-the-knee popliteal; panel D is the calf; and panel E is the ankle. Panels F to L were obtained at 1-year follow-up. Journal of Vascular Surgery 2010 52, 199-204DOI: (10.1016/j.jvs.2009.12.048) Copyright © 2010 Society for Vascular Surgery Terms and Conditions