Hyperbaric Oxygen Therapy in Grade IV Peripheral Arterial Disease with Severe Comorbidity
Georgios Vertsonis1, Ferruccio Di Donato1, Nadia Franchini1, Alessandra Morelli1, Lidia Tonti1. 1Centro Iperbarico di Bologna (Quarto Inferiore (BO), Italy)
Aim: A large number of patients with grade IV peripheral artery disease (PAD) cannot afford risk of revascularization surgery cause a severe comorbidity. Hyperbaric oxygen therapy (HBOT) has been reported as a valid a secure alternative treatment.
Methods: A 70 years old Caucasian male, suffering from a grade IV peripheral artery disease (according to Fontaine’s clinical classification) with bilateral calcaneus infected ulcers, has reached our Center after he has non been eligible to revascularization due to comorbidity for ischemic chronic cardiopathy, mitral aortic valvulopathy, diabetes mellitus insulin dependent, chronic renal failure, multifactor anemia and obstructive sleep apnea syndrome in C‐PAP treatment. The patient, in 13 months period, underwent three cycles of 22 hyperbaric oxygen therapies, breathing 100% oxygen for 75 minutes at 2,5 atmosphere (ATA), daily for five days a week. The initial peripheral transcutaneous oximetry (PtcO2) was 43 mmHg on the right foot and 34 mmHg on the left foot. PtcO2 increased during HBOT, reaching 1133 mmHg on the right foot and 727 mmHg. During the same period patient underwent a three times a week advance wound care, a cycle of specific antibiotic therapy for Staphlococcus Aureus.
Results: Hyperbaric oxygen therapy, by increasing local oxygen supply, has encouraged ulcer healing preserving the low extremities.
Conclusion: Hyperbaric oxygen therapy has been a successful alternative treatment in an invaliding grade IV peripheral artery disease not eligible to revascularization surgery for severe comorbidity.
sumber : Georgios Vertsonis1, Ferruccio Di Donato1, Nadia Franchini1, Alessandra Morelli1, Lidia Tonti1. 1Centro Iperbarico di Bologna (Quarto Inferiore (BO), Italy)
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