JET2019

Presentation information

Presentation Awards

[L1-1] Presentation Awards
Heat-1 Critical limb ischemia

Fri. Feb 22, 2019 9:00 AM - 10:30 AM HallL-1 (Nexus)

Moderator: Tomoyasu Sato(Tsuchiya general hospital),Mark Burket(University of Toledo)
Panelists: Daijiro Akamatsu(Department of general surgery),Kohei Asada(Okamura Memorial Hospital)

[MO-2] Presentation Awards

Kazuki Tobita (Shonan Kamakura General Hospital)

A 12-year old man admitted for critical limb ischemia (CLI) with Rutherford class 5. He did not have any medical past history and referred from local clinic. He had right toe ulcers and complained of severe rest pain. Angiography revealed moderate narrowing in right SFA and occlusion in right anterotibial artery (ATA) and posterotibial artery (PTA). His lower limbs vessel in the left side was intact. At first, we started antiplatelet therapy with clopidogrel and cilostazol, and vasodilator with prostaglandin. However, his skin perfusion pressure (SPP) level decreased gradually and toe pain was worsening. We performed endovascular therapy (EVT) for right below the knee. We could dilated ATA and PTA easily, however, severe recoil and spasm were confirmed. Finally, we performed EVT 3 times but his symptom did not improve. At last, we employ methylprednisolone according to cholesterol embolism. His symptom and SPP level improved and he could discharge without toe pain. Methylprednisolone was gradually decreased and stopped, and his toe ulcer healed in 3 months after discharge.

We had very rare case of young CLI patient. We consider in this report, including the etiology.