Patient records
Name: Carlos Silva
Age: 70
Nationality: Brazil (São Paulo)
Diagnosis: Lower extremity arteriosclerosis obliterans (Rutherford grade 4, long segment occlusion of the left superficial femoral artery, rest pain)
Treatment Hospital: Department of Vascular Surgery, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
Mr. Carlos is a passionate samba dancer who, even in his seventies, still enjoys swaying to the music on the streets of Rio. However, for the past six months, a deep, excruciating pain has rendered him unable to walk. His left leg suffers from arteriosclerosis obliterans, where the blood vessels are completely blocked by plaque resembling limescale, causing severe ischemia. Even when still, his toes burn as if on fire, his skin is cold and purple, and he faces the risk of amputation if the condition worsens. He often wakes up in the middle of the night in agony, clutching his foot, his eyes filled with despair.
In Brazil, doctors attempted traditional balloon dilation, but the procedure failed because the occluded segment was too long and the plaque too hard, making it impossible for the guidewire to pass through. Doctors told him that arterial bypass surgery might be necessary, but this was highly invasive and risky due to his advanced age. When Carlos's family learned about a "laser-based blood vessel opening" technique in China through us, they felt like they had grasped at a last straw. Upon receiving the medical records, our case manager immediately sent his CTA images and vascular ultrasound reports to the Department of Vascular Surgery at Ruijin Hospital, affiliated with Shanghai Jiao Tong University School of Medicine. The expert team there has a unique and effective approach to treating complex lower extremity arterial occlusions.
Before the consultation, our medical consultant explained to Carlos with a vivid analogy: "Traditional balloon dilation is like forcibly squeezing out 'scale,' but your 'scale' is too hard. The experts at Ruijin Hospital will use an excimer laser ablation technique, which is like an 'optical fiber cable.' Through ultraviolet light pulses, it 'vaporizes' the plaque blocking the blood vessel, opening a channel first, and then using a medicated balloon to repair the blood vessel and prevent it from becoming blocked again."
During the procedure, the surgery was performed under DSA guidance. The surgeon carefully advanced the laser catheter to the occluded segment and activated the laser. On the imaging, we could clearly see the hard plaque gradually being eroded, creating a channel under the laser's influence. Subsequently, a drug-coated balloon was inserted for full dilation, ensuring the anti-proliferative drug adhered tightly to the vessel wall. Post-operative angiography showed that blood flowed smoothly, reaching Carlos's foot. His toes changed color from purple to red right on the operating table, and the temperature returned to normal. Carlos exclaimed excitedly, "I feel like my foot is alive again!"
During the post-operative follow-up phase , we developed a rigorous rehabilitation plan for Carlos, including daily walking exercises and foot care. After returning home, he recorded his daily walking distance and pain score using our app. Our case manager would video chat with him regularly to check on the healing of his foot wound. Six months later, Carlos sent a video of himself wearing his gleaming leather shoes, dancing a lively samba again on the streets of São Paulo. He said, "It was you and the Chinese doctors who helped me regain my rhythm of walking."