Satake Akinori, Nakano Yusuke, Niwa Toru, Ando Hirohiko, Takashima Hiroaki, Amano Tetsuya
Department of Cardiology, Narita Memorial Hospital, Toyohashi, Japan.
Department of Cardiology, Aichi Medical University, Nagakute, Japan.
SAGE Open Med Case Rep. 2023 Jan 17;11:2050313X221149359. doi: 10.1177/2050313X221149359. eCollection 2023.
Recently, a new low-density lipoprotein apheresis device (Rheocarna; Kaneka Corporation, Osaka, Japan), a blood purification therapy, was approved in Japan for managing chronic limb-threatening ischemia with refractory ulcers. Here, we describe a case of chronic limb-threatening ischemia that was treated with the Rheocarna. A 65-year-old Asian man with an ulcer on the right heel was admitted to our hospital. Angiography revealed chronic total occlusion with severe calcification of the anterior tibial, peroneal, and posterior tibial arteries. The patient underwent distal bypass of the saphenous vein; however, the bypass was occluded in the early postoperative period. The Rheocarna was used, and the ulcers improved significantly postoperatively. Although endovascular treatment was eventually performed on the occluded bypass graft to completely heal the ulcer, the Rheocarna could be an alternative treatment option in challenging cases of chronic limb-threatening ischemia.
最近，一种新的低密度脂蛋白单采装置（Rheocarna；日本大阪钟渊化学工业株式会社），一种血液净化疗法，在日本被批准用于治疗伴有难治性溃疡的慢性肢体威胁性缺血。在此，我们描述一例使用Rheocarna治疗的慢性肢体威胁性缺血病例。一名65岁的亚洲男性因右足跟溃疡入住我院。血管造影显示胫前动脉、腓动脉和胫后动脉慢性完全闭塞并伴有严重钙化。患者接受了大隐静脉远端旁路移植术；然而，旁路在术后早期闭塞。使用了Rheocarna，术后溃疡明显改善。尽管最终对闭塞的旁路移植物进行了血管内治疗以使溃疡完全愈合，但在具有挑战性的慢性肢体威胁性缺血病例中，Rheocarna可能是一种替代治疗选择。
