Hypertensive extracorporeal limb perfusion for critical limb ischemia

Abstract

The collateral circulation of ischemic limbs can be augmented and regulated by a connection to an extracorporeal centrifugal pump, with isolation from the systemic circulation provided by balloons and with an access system providing repeatable pump connections. Major amputation may be avoided in selected cases.

Challenges in Chemotherapy Delivery: Comparison of Standard Chemotherapy Delivery to Locoregional Vascular Mass Fluid Transfer

“…Of paramount importance to cellular chemotherapy absorption is the concept of 'cellular hyperperfusion' which is defined as an increase in inflow pressure beyond the pressure that can be attained from the normal cardiac cycle. In the past, the technique of limb hyperperfusion has been successfully utilized to overcome high peripheral resistance in critical limb ischemia [68][69][70]. Figure 5 shows thermographic images of a gangrenous foot hyperperfused at 150% of the normal inflow pressures throughout the cardiac cycle [71,72].…”

Antihypertensive treatment in critical limb ischaemia

“…Additionally, the concept of increasing blood pressure and thereby increasing collateral circulation in an ischaemic extremity seems intuitionally appealing. Regional hyperperfusion via extracorporeal limb perfusion has been evaluated in CLI with promising results [13], and benefits of sequential pneumatic compression have been suggested in prevention of minor amputation, prolonging amputation-free survival, and improving rest pain in patients with non-reconstructable CLI [14]. Many factors would theoretically support a benefit of aggressive blood pressure lowering also in CLI, however.…”

Successful application of extracorporeal circulation compression perfusion in the treatment of diabetic foot: a retrospective cross-sectional study

“…Additionally, amputation was delayed in four patients by an average of 4 months during long-term treatment over 22 months (range: 12–54 months). 8 …”

“…Both methods expand the stenosis site of the diseased vessel, increase the blood supply to the tissue by increasing blood flow through the cross section of the vessel per unit time, and promote the reconstruction of the peripheral vascular network during perfusion. 8 …”

“…Both methods expand the stenosis site of the diseased vessel, increase the blood supply to the tissue by increasing blood flow through the cross section of the vessel per unit time, and promote the reconstruction of the peripheral vascular network during perfusion. 8 When we reviewed our department's case records, we found that some patients received ECCP intervention, while others received routine treatment, and the therapeutic effects differed. We performed this retrospective study to evaluate the correlation between ECCP and changes in foot microcirculatory perfusion.…”