Wound Healed after Serranator
Sarang Mangalmurti, MD
Bryn Mawr Hospital
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So this is a patient who was referred to me by a local podiatrist for a non-healing wound in the forefoot on exam. She has a Doppler signal but it's not very strong. And as you can see from the anatomy, she has a totally occluded distal anterior tibial vessel that's only filling from collateral flow. So, I was able to get across the occlusion with a wire. But I had quite a bit of difficulty getting a support catheter to cross. So I ended up having to modify that plaque in the occlusion with a very small laser fiber. And that created a channel, after which I was then able to introduce a Serranator balloon once the serenade are crossed, and that's a 2.5mm Serranator that you see crossing.
I was able to perform angioplasty on this total occlusion, and you see the result afterward. It's an exceptional result in this chronic total occlusion that was very, very tight and very tough to cross. And this is exactly the kind of result we're looking for. It's a wide open vessel with a large lumen diameter afterword and excellent flow. There's no dissection. This is not an area that you'd want a stent or especially around the ankle area. And the good news is that I follow this patient in the office. And after six weeks with wound care and significantly improved blood flow to her forefoot, she healed her wound.
