Ashwin Pai (1) *, Sriram Bhat (2), HS Shankar Ram (3), Sheila R Pai (4) ,Shobha G Pai
Introduction /Aim: The objective of this paper is to study the efficacy of omental transplantation in peripheral vascular disease.
Results: This study is a prospective study done on a group of 30 patients. This study constituted patients of the age group between 23- 50 years. The patients were all male. The patients were Beedi smokers (A beedi is a rolled up tobacco without filter) and on an average the patients smoked between 10- 30 beedis per day. The chosen cases did not have posterior tibial, anterior tibial and dorsalis pedis artery pulsations. In 20 of our cases, popliteal artery pulsation was absent. 11 cases had non-healing ulcers and 20 had dry gangrene of toe/toes or forefoot, with rest pain. The patients were assessed at post operative day 7, at 1 month and 3 months after the procedure. Intermittent claudication was relieved in 25 patients (83%). Rest pain which was present in 15 patients (50%) before the procedure was relieved in all the patients at the end of 3 months (100%). Healing of ulcer occurred in 10 out of 11 patients (91%). The healing of amputated toe site occurred in 15 out of 20 patients during 3 months follow-up (75%). The O2 saturation measured by pulseoximetry measured in all patients increased from 72% on an average to 94% after 3 months of follow-up.
Conclusion: Patients presenting with terminal limb ischemia due to Thromboangitis Obliterans often have no hope for limb salvage, for such cases, omental transplantation offers a procedure which can result in improved limb circulation and limb salvage. The level of omental transplantation had no bearing on the improvement in symptoms thereby supporting the potency of omental pedicle graft to induce neoangiogenesis and thereby improving circulation of surrounding tissues.
