Limb Salvage vs. Amputation – Dr. Herman Case Study Overview

A leading authority on Peripheral Artery Disease and Critical Limb Ischemia, Dr. Herman has earned a reputation as one of the most skilled interventional radiologists on the east coast. In addition to his work through Endovascular & Amputation Prevention, LLC located in West Orange, New Jersey.

Patient History and Consultation

  • A 69-year-old male with multiple cardiovascular risk factors was referred 2 months status post amputation of the right great toe region due to osteomyelitis.  He has continued non-healing at the amputation site.
  • PMHx: HTN, DM, HLD, prior left toe amputation.
  • Former smoker.
  • Medications:
    – Metformin – 1,000 mg
    – Glipizide – 10 mg
    – Tradjenta – 5 mg
    – Amlodipine – 10 mg
    – Simvastatin – 20 mg
    – Aspirin – 81 mg
    – Clopidogrel – 75 mg

Treatment Plan

  • Increase statin
  • Maintain anti-plt therapy
  • Nutrition discussion
  • Arterial imaging
  • Angiogram

Initial angiogram: 12/1/20

Initial angiogram: 12/1/20

Technical point

Technical point

Post Intervention Images

Post Intervention Images

Clinical Image Progression

Clinical Image Progression

Repeat Intervention 1/19/21

Repeat Intervention 1/19/21

2nd proc – “Kissing” Balloon and Pedal Loop

2nd proc – “Kissing” Balloon and Pedal Loop

Diligent Care is needed

  • Medical management
  • Wound management
  • Vascular management
  • Expectation management
  • Multi-discipline approach

Limb salvage needs DILIGENT

Request a consultation at your nearest American Endovascular center today.