In this episode, Dr. Ally Baheti interviews interventional radiologist Dr. Lorenzo Patrone about his recent multidisciplinary editorial entitled "The 'Woundosome' Concept and Its Impact on Procedural Outcomes in Patients With Chronic Limb-Threatening Ischemia.”

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SYNPOSIS

Dr. Patrone explains his interest in critical limb ischemia (CLI) and describes how he reached out to colleagues around the world with the intention of drafting a paper that summarizes research in below-the-ankle interventions and increases awareness of the woundosome concept.

He explains the woundosome concept, which aims to understand how each patient’s foot vasculature influences the effectiveness of below-the-ankle interventions and tissue healing. Understanding each patient’s anatomy, having adequate imaging of the foot, obtaining pedal acceleration times, and using micro-oxygen sensors are strategies to assess wound perfusion, which is integral for treatment planning and prognosis. He illustrates these techniques in a case study of a non-healing wound.

Finally, Dr. Patrone shares some technical tips for below-the-ankle interventions, including the benefits of ipsilateral antegrade access, sheath selection, and strategic contrast administration.

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TIMESTAMPS

00:00 - Introduction

02:25 - Multidisciplinary and Global Collaboration

05:59 - Explaining the Woundosome Concept

07:51 - Understanding Wound Perfusion

10:20 - Assessing the Effectiveness of Revascularization

20:09 - Case Example with Pictures

28:07 - Technical Tips for CLI Interventions

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RESOURCES

Find Your Algorithm (FYA):

https://fya-congress.com/

The "Woundosome" Concept and Its Impact on Procedural Outcomes in Patients With Chronic Limb-Threatening Ischemia:

https://journals.sagepub.com/doi/10.1177/15266028241231745?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed

Vascular imaging of the foot: the first step toward endovascular recanalization (Manzi):

https://pubmed.ncbi.nlm.nih.gov/21997985/

BASIL-2 Trial:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00462-2/fulltext

BackTable VI Ep. 90- Pedal Acceleration Time for Limb Salvage with Jill Sommerset and Dr. Mary Constantino:

https://www.backtable.com/shows/vi/podcasts/90/pedal-acceleration-time-for-limb-salvage

The First-in-Man "Si Se Puede" Study for the use of micro-oxygen sensors (Montero-Baker):

https://pubmed.ncbi.nlm.nih.gov/26004327/

PEDRA Perfusion Monitoring:

https://www.pedratech.com/

Armada XT Balloon:

https://www.cardiovascular.abbott/us/en/hcp/products/peripheral-intervention/peripheral-dilatation-catheters/armada-14.html