2020 UAB Cardiovascular Institute Annual Report CVI Annual Report 2019-2020 6 | Page 24

DIABETIC FOOT ULCERS
SELECTED PUBLICATIONS
• Pathological insights into persistent mitral regurgitation following continuous flow left ventricular assist device
implantation (2019) Indranee Rajapreyar, J. Eduardo Rame, Paul Fiorilli, Salpy V. Pamboukian, Charles W. Hoopes
et al. J Heart Lung Transpl, in press.
• Management of reproductive health after cardiac transplantation (2019) Rajapreyar I, RG Sinkey, JM Jolly, S
Pamboukian, A Lenneman, C Hoopes, et al. J Matern Fetal Neonatal Med 7:1-10.
• Bridging to lung transplantation with double-lumen venovenous extracorporeal membrane oxygenation. (2019)
Yanagida R, Seethamraju H, Davenport DL, Tribble TA, Zwischenberger JB, and C Hoopes Int J Artif Organs 42(11):
621-627.
• Evaluation of flow modulation approaches in ventricular assist devices using an in-vitro endothelial cell culture
model (2019) Haglund TA, NS Rajasekaran, B Smood, GA Giridharan, C Hoopes, et al. J Heart Lung Transpl
38(4):456-465.
• Improvement in Kidney Function After Ventricular Assist Device Implantation and Its Influence on Thromboembolism,
Hemorrhage, and Mortality (2019) Davis BH, Boehme AK, Pamboukian SV, Allon M, George JF, et al. ASAIO, in
press.
• Performance of Noninvasive Assessment in the Diagnosis of Right Heart Failure After Left Ventricular Assist Device
(2019) Joly JM, El-Dabh A, Marshell R, Chatterjee A, Smith MG et al ASAIO 65:449-455.
• Lung Transplantation for Cystic Fibrosis and Non-cystic Fibrosis Bronchiectasis: A Single-Center Experience (2019)
Rusanov V, Fridman V, Wille K, Kramer MR Transpl Proc 51:2029-2034 .
• Clinical Outcomes of Paramyxovirus Infections in Lung Transplant Recipients Treated With Oral Ribavirin: A Two-
Center Case Series (2019) Garcia B1, Sharma N, Johnson K, Salgado J, Wille K. Exp Clin Transplant 17:393-397.
• Cooper DKC, Hara H, Iwase H, Banks C, Cleveland DC. An approach to induction of tolerance to pig cardiac
xenografts in neonates. Xenotransplantation. 2018, 25; e12454 doi: 10.1111 PMID: 30125392
• Cleveland DC, Banks Adam, MS, Hara H, Carlo, W, Mauchley D, Cooper DK. The Case for Cardiac
Xenotransplantation in Neonates: Is now the time to reconsider xenotransplantation for hypoplastic left heart
syndrome? Pediatric Cardiology. 2019. Feb. 40(2). 437-444. PMID: 30302505
ADVANCED LIMB
PRESERVATION PROGRAM
The UAB Advanced Limb Preservation Program aims to
seamlessly integrate vascular and podiatric surgery in
both the outpatient and inpatient settings, with the goal
of reducing amputations in patients with diabetes and
peripheral artery disease. It is the only program of its
kind in Alabama.
PERIPHERAL VASCULAR
DISEASE
UAB Medicine’s vascular and podiatric specialists within
the Division of Vascular Surgery and Endovascular
Therapy provide expert treatment of multiple circulatory
conditions using a broad range of services that includes
medical therapy, endovascular therapy, and surgical
reconstruction/bypass.
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ADVANCED LIMB PRESERVATION PROGRAM
UAB Cardiovascular Institute Annual Report
The recent addition of two podiatric surgeons to the faculty has greatly increased the ability to provide timely and
effective treatment to patients with diabetic foot complications. Diabetes-related foot complications are common
and costly. Up to 34% of individuals with diabetes will develop an ulcer during their lifetime, and 84% of lower limb
amputations are preceded by a foot ulcer. The five-year mortality rate following the development of a foot ulcer or
a major lower limb amputation is worse than many forms of cancer.
Multidisciplinary care is provided to chronic limb-threatening ischemia (CLTI) patients through the so-called “toe
and flow” model, as illustrated below.
“TOE AND FLOW” MODEL
Wound Care
Plastic Surgery
Podiatry
TOE
Infectious Disease
CLTI Patient
FLOW
Endocrinology
THORACIC TRANSPLANTATION &
MECHANICAL CIRCULATORY SUPPORT
Vascular Surgery
Orthopaedic Surgery
Cardiology
Nephrology
VASCULAR SURGERY & ENDOVASCULAR THERAPY
FOR ARTERIAL OCCLUSIVE DISEASE
JULY 2014-JUNE 2019 (N=2537)
OPEN (N=1153)
ENDO (N=1384)
A
B
C
D
E
F
Figure: 81-year-old female with non-healing first-toe amputation site. (A) Near occlusive lesion in the poplitea
artery. Mid-calf occlusion of the anterior tibial artery. Tibioperoneal trunk occlusion. (B) Reconstitution of the
anterior tibial artery via collaterals. (C) Single-vessel runoff to the foot via the dorsalis pedis artery. (D) Successful
revascularization of the popliteal artery with balloon angioplasty. (E) Recanalization of the anterior tibial artery
after obtaining a “through and through” wire from antegrade common femoral access and retrograde pedal
access. (F) Restoration of inline flow to the foot through the dorsalis pedis artery.
HIGHLIGHTS
• Direct collaboration between vascular surgeons and vascular and diabetic podiatry experts on every patient
with chronic limb-threatening ischemia
• Advanced endovascular techniques, including atherectomy (laser and mechanical), balloon angioplasty and
stenting, peripheral arterial bypass, thrombolysis and thrombectomy, and peripheral and visceral aneurysm
repair
• Non-invasive arterial testing and diagnostic imaging in a state-of-the-art vascular lab
• Vascular medical evaluation, including risk factor assessment and non-operative management options
uabmedicine.org
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