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

Technical point

Post Intervention Images

Clinical Image Progression

Repeat Intervention 1/19/21

2nd proc – “Kissing” Balloon and Pedal Loop

Diligent Care is needed

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

Request a consultation at your nearest American Endovascular center today.