Case Reviews

Shockwave E8 for the Treatment of the Posterior Tibial and Lateral Plantar Arteries

55-year-old male patient with insulin-dependent diabetes presents with gangrene affecting the second and third toes of the left foot. He exhibits absent foot pulses, while the popliteal pulse is palpable. The patient is scheduled for a hybrid procedure that includes the amputation of both toes and revascularization. His past medical history is significant for hypertension and hyperlipidemia. Currently, he is unable to work due to chronic limb-threatening ischemia (CLTI).

 

  • Baseline angiograms showing normal inflow/outflow, but narrowed distal PT and heavily stenosed lateral plantar arteries
    Baseline angiograms showing normal inflow/outflow, but narrowed distal PT and heavily stenosed lateral plantar arteries. IVUS confirming significant stenosis of the distal PT and lateral plantar arteries.
  • 10 cycles of 3.5 mm Shockwave E8 delivered in distal posterior tibial artery and proximal lateral plantar arch.
    10 cycles of 3.5 mm Shockwave E8 delivered in distal posterior tibial artery and proximal lateral plantar arch.
  • foot angiograms showing widely patent distal PT and lateral plantar arteries with excellent digital blood supply to 2nd and 3rd toes
    Final foot angiograms showing widely patent distal PT and lateral plantar arteries with excellent digital blood supply to 2nd and 3rd toes targeted for amputation. Foot pulses present following the case

 

Case courtesy of Dr. Ash Patel – Guy’s & St Thomas’ NHS Foundation Trust, London.

Dr. Ash Patel is a paid consultant of Shockwave Medical.