Posters
Presenting Author Academic/Professional Position
Medical Student
Academic Level (Author 1)
Medical Student
Academic Level (Author 2)
Medical Student
Presentation Type
Poster
Discipline Track
Clinical Science
Abstract Type
Case Report
Abstract
Background: Hyperbaric oxygen therapy is a long-used yet understudied intervention for a wide array of conditions. In the case of our patient with acute limb ischemia secondary to cholesterol emboli, the use of hyperbaric oxygen therapy after attempted thrombectomy and thrombolysis was utilized to promote tissue oxygenation and wound healing with the goal of preserving the patient’s limb. What makes this case novel is that an understudied treatment method was used to preserve the patient’s limb after the recommended treatment options been exhausted. This case highlights the need for more studies on the effectiveness of hyperbaric oxygen therapy in the setting of acute limb ischemia, as it may provide additional support in oxygenating limb tissue even before other treatment options have been attempted and failed.
Case presentation: Our patient is a 60-year-old Hispanic woman with a past medical history of essential hypertension and uncontrolled type 2 diabetes mellitus who presented to the emergency department with a chief complaint of chest pain. She was diagnosed with an ST-elevation myocardial infarction that was promptly treated with percutaneous coronary intervention. The patient soon developed Rutherford stage IIb acute limb ischemia to the right foot. Thrombectomy, thrombolysis with tPA, and angioplasty were all attempted and failed to effectively restore limb perfusion. The patient reported having present but minimal sensation and motor ability of the right foot and digits. On exam, dorsalis pedis and posterior tibial pulses were absent, and the right great toe appeared purple. Her leukocyte count and blood glucose were consistently elevated. It was determined that her healing was impaired due to the uncontrolled diabetes mellitus and hypertension. These would be medically managed, and she would have 30 sessions of hyperbaric oxygen therapy during this time in hopes of promoting healing, improving tissue oxygenation, and reducing inflammation. She was discharged from the hospital after 1 week of hyperbaric oxygen therapy and returned daily to finish her 30 sessions. She reported retaining minimal sensation and motor ability to the right foot. The tissue of the right root after 1 week remained darkened but appeared closer to her original skin tone compared to when oxygen therapy was initiated.
Conclusions: Our goal was to promote the perfusion and healing of our patient’s right foot to eliminate the need for amputation. When several other methods of reperfusion failed, medical management of her chronic conditions and hyperbaric oxygen therapy were initiated. Our patient was able to retain very minimal sensation and motor ability after her in-patient oxygen therapy sessions, which kept our team from moving forward with amputation at the time. We are not able to extrapolate the outcome of our patient to prove the effectiveness of hyperbaric oxygen therapy, however this case does highlight the need for further research to understand what place with therapy could hold in the care for patient with acute limb ischemia. Given our understanding of its ability to promote tissue oxygenation and reduce inflammation, it is possible it could support healing and treatment even sooner in the management of this condition.
Recommended Citation
Fonseca, Josue and Callan, Andrew B., "The Use of Hyperbaric Oxygen Therapy in the Setting of Acute Limb Ischemia" (2025). Research Symposium. 11.
https://scholarworks.utrgv.edu/somrs/2025/posters/11
The Use of Hyperbaric Oxygen Therapy in the Setting of Acute Limb Ischemia
Background: Hyperbaric oxygen therapy is a long-used yet understudied intervention for a wide array of conditions. In the case of our patient with acute limb ischemia secondary to cholesterol emboli, the use of hyperbaric oxygen therapy after attempted thrombectomy and thrombolysis was utilized to promote tissue oxygenation and wound healing with the goal of preserving the patient’s limb. What makes this case novel is that an understudied treatment method was used to preserve the patient’s limb after the recommended treatment options been exhausted. This case highlights the need for more studies on the effectiveness of hyperbaric oxygen therapy in the setting of acute limb ischemia, as it may provide additional support in oxygenating limb tissue even before other treatment options have been attempted and failed.
Case presentation: Our patient is a 60-year-old Hispanic woman with a past medical history of essential hypertension and uncontrolled type 2 diabetes mellitus who presented to the emergency department with a chief complaint of chest pain. She was diagnosed with an ST-elevation myocardial infarction that was promptly treated with percutaneous coronary intervention. The patient soon developed Rutherford stage IIb acute limb ischemia to the right foot. Thrombectomy, thrombolysis with tPA, and angioplasty were all attempted and failed to effectively restore limb perfusion. The patient reported having present but minimal sensation and motor ability of the right foot and digits. On exam, dorsalis pedis and posterior tibial pulses were absent, and the right great toe appeared purple. Her leukocyte count and blood glucose were consistently elevated. It was determined that her healing was impaired due to the uncontrolled diabetes mellitus and hypertension. These would be medically managed, and she would have 30 sessions of hyperbaric oxygen therapy during this time in hopes of promoting healing, improving tissue oxygenation, and reducing inflammation. She was discharged from the hospital after 1 week of hyperbaric oxygen therapy and returned daily to finish her 30 sessions. She reported retaining minimal sensation and motor ability to the right foot. The tissue of the right root after 1 week remained darkened but appeared closer to her original skin tone compared to when oxygen therapy was initiated.
Conclusions: Our goal was to promote the perfusion and healing of our patient’s right foot to eliminate the need for amputation. When several other methods of reperfusion failed, medical management of her chronic conditions and hyperbaric oxygen therapy were initiated. Our patient was able to retain very minimal sensation and motor ability after her in-patient oxygen therapy sessions, which kept our team from moving forward with amputation at the time. We are not able to extrapolate the outcome of our patient to prove the effectiveness of hyperbaric oxygen therapy, however this case does highlight the need for further research to understand what place with therapy could hold in the care for patient with acute limb ischemia. Given our understanding of its ability to promote tissue oxygenation and reduce inflammation, it is possible it could support healing and treatment even sooner in the management of this condition.
