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Perspectives in Circulation Today
Where can patients seek help in Ohio when the local vascular surgeons can not help them?
The End-Stage Foot?
Ulcerated Feet Salvaged by Circulator Boot and John F. Boyle, D.P.M
Case 1
This 75 year old female patient presented wth a past medical history that included type 2 diabetes mellitus treated with oral agents, coronary heart disease, COPD secondary to tobacco use, hypercholesterolemia, hypertension and lower extremity arterial disease. Her surgical history included bilateral AI bypass in 1995 and subsequent angioplasty with stent placement in 1997 of the right lower extremity. Her pictures tell her story:
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claudication, rest/nocturnal pain, non-palpable pulses and trophic skin changes associated with her ischemia. She was treated in Dr. Boyle's wound care clinic with the end-diastolic pneumatic compression boot (Circulator Boot-TM) three times a week for nine months. |
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Case 2
This 88 year old male presented in Dr. Boyle's office with complaints of rest/night pain, a painful ulceration on the posterior lateral aspect of the right calcaneus, and trophic changes associated with arterial insufficiency. He had a history of coronary heart disease but was otherwise healthy. An aorto-bifemoral angiogram was performed showing mederate multi-focal atherosclerotic irregularities and stenoses involving the right SFA with only one vessel run-off. The patient was considered high risk for vascular surgical intervention. He was referred for evaluation and placed on end-diastolic pneumatic compression therapy (Circulator Boot-TM) and local wound care. Subsequent complete resolution and healing of the wound occurred approximately 16 weeks after institution of the boot therapy.
 Heel on presentation. |
 Heel just prior to complete healing. |
Comments: Where in Ohio can patients go? The Southern Ohio Foot and Ankle Associates, Inc. and John F. Boyle, D.P.M. would be a good place to start (Chillicothe, Ohio, 740-775-7800). For those who would like to learn more, you will find four posters at the World Union of Wound Healing Societies Meeting in Toronto, June 4th-8th, 2008. We are grateful to Dr. Boyle for his providing us with these pictures and text. .