Rheocarna^® as an alternative therapeutic option for patients with chronic limb-threatening ischemia: A case report

Abstract

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.

A Case of Refractory Heel Ulcer Complicated by Moderate Osteomyelitis and Cellulitis Successfully Treated With Rheocarna

“…It is indicated for ASO patients with ulcers that are not amenable to revascularization, with no limits to hypercholesterolemia or special equipment requirements. Clinical trials have shown healing effects in refractory ulcers 6 , and improved peripheral circulation has been reported in patients with occluded bypass grafts 12 . However, clinical trials have not included patients with ulcers more proximal to the Lisfranc joint or osteomyelitis more proximal to the metatarsal bones.…”

Correlation between bradykinin concentration and blood pressure during Rheocarna therapy: A single‐center case series

“…Chronic limb-threatening ischemia (CLTI) is a clinical syndrome characterized by the presence of peripheral artery disease (PAD) combined with rest pain, gangrene, or lower limb ulceration for over 2 weeks [1][2][3]. CLTI accounts for 20%-30% of PAD, and the 1-and 5-year survival rates of patients with CLTI are 73% and 27%, respectively [4].…”

Rheocarna® therapy after distal bypass surgery

“… 3 Although there are some case reports of patients with distal bypass obstruction who were treated with Rheocarna ® and obtained good results, it is difficult to improve with Rheocarna ® therapy alone. 4 Although there have been reports showing the usefulness of Rheocarna ® therapy after catheterization, there have been no reports on its usefulness after distal bypass surgery.…”